Evaluation of skin viability in dogs, using transcutaneous carbon dioxide and sensor current monitoring

Transcutaneous oxygen monitoring is commonly used in human beings to assess skin viability. Little attention has been directed toward the use of transcutaneous carbon dioxide (P(CO2.TC)) monitoring for the same purpose. The application of P(CO2.TC) monitoring for evaluating skin viability in dogs was investigated. The changes in P(CO2.TC) and local power reference (LPR) values were measured from 16 skin flaps created along the lateral hemithoraces of 4 dogs. Transcutaneous P(CO2) and LPR values were serially recorded from the base and apex of each flap for 12 hours. A single measurement was obtained from each flap base and apex 24 hours after surgery. Arterial blood gas analyses were obtained to compare central P(CO2) values with peripheral skin P(CO2) values. The flaps were observed for 4 days and then harvested for histologic examination. Full-thickness skin biopsy specimens were obtained 24 hours after surgery and when the flaps were harvested to evaluate the viability of the apex and base of the flaps. A subjective grade was assigned to all skin biopsy specimens during histologic examination. For all measurements, a significant difference was found between the P(CO2.TC) values for apices and bases of the flaps. The mean P(CO2.TC) for all bases was 52.66 mm of Hg +/- 2.24 (SEM), and the mean P(CO2.TC) for all apices was 106.4 mm of Hg +/- 2.44. The regional carbon dioxide index (apex P(CO2.TC)/base P(CO2.TC) was 2.02. A significant difference was not found between the LPR values for bases and apices. The mean LPR for all bases was 253.23 mW +/- 4.06, and the mean LPR for all apices was 243.53 mW +/- 4.49. A significant difference was found between the histologic grades assigned to the collective bases and apices 4 days after creation of the flaps. A difference was not found between the collective bases and apices 24 hours after flap creation. On the basis of our findings, transcutaneous carbon dioxide monitoring is a useful method of evaluating skin viability in dogs.