SPP vs TcPO2 Clinical Comparison
Peer-reviewed clinical studies demonstrate that Skin Perfusion Pressure (SPP) is superior to Transcutaneous Oxygen (TcPO2/TCOM) for wound healing prediction, PAD detection, and overall diagnostic accuracy.
| Metric | SPP | TcPO2/TCOM | Advantage |
|---|---|---|---|
| Wound Healing Prediction | 93.2% | 63.9% | SPP +29.3% |
| PAD Detection Rate | 96.2% | 61.5% | SPP +34.7% |
| Mean Test Time | 6.7 min | 35.4 min | SPP 80% faster |
| Sensitivity | 90% | 66% | SPP +24% |
| Annual Testing Cost | $904 | $4,655 | SPP saves $3,751 |
| Annual Test Time | 39.67 hrs | 204 hrs | SPP saves 164 hrs |
Source: SAWC 2009 - Bailey, Schechter et al.; Wounds 2009 - Lo et al.; UHMS 2008 - Schechter, Bailey et al.
| Capability | SPP | TcPO2 |
|---|---|---|
| Works with Calcified Arteries | Yes | Yes |
| Works with Edema | Yes | No |
| Works with Callus | Yes | No |
| Can Test Plantar Foot | Yes | No |
| Works with Anemia/Hypoxia | Yes | No |
| Calibration Required | No | Yes |
| Contact Gel Required | No | Yes |
| Heated Electrodes Required | No | Yes (42-44°C) |
| Labor Intensive | No | Yes |
| Training Required | Minimal | Extensive |
| Post-Revasc Results | Immediate | 3-4 weeks |
SAWC 2009 - Bailey, Schechter et al.
"TcPO2 and SPP Evaluation: A Direct Comparison of Technologies for the Assessment of Wound Healing and Vascular Disease Detection"
Prospective, IRB approved, 100 patient investigation comparing SPP/PVR vs TCOM/ABI.
Wounds 2009 - Lo et al.
"Prediction of Wound Healing Outcomes in 100 Patients Using Skin Perfusion Pressure and Transcutaneous PO2"
Prospective, single center study to determine accuracy of SPP vs TcPO2 for wound assessment.
Journal of Vascular Surgery 2008 - Yamada et al.
"Clinical Reliability and Utility of Skin Perfusion Pressure Measurement in Ischemic Limbs: Comparison with Other Noninvasive Diagnostic Methods"
403 limbs from 211 patients with arteriosclerosis obliterans. Half had diabetes or dialysis.
Am J Kidney Disease 2006 - Okamoto et al.
"Peripheral Arterial Occlusive Disease is More Prevalent in Patients with Hemodialysis: Comparison with Multidetector-Row CT"
Compared ABI, TBI, TcPO2, and SPP in hemodialysis patients against CT for PAOD detection.
Wounds 2008 - Tsuji et al.
"Importance of Skin Perfusion Pressure in Treatment of Critical Limb Ischemia"
69 ischemic limbs with foot ulcers/gangrene in 47 patients. Studied SPP for predicting wound healing and selecting reconstructive procedures.
Patients with diabetes have the highest risk for developing PAD, CLI, and amputation. They often have below-the-knee and pedal arterial disease resulting in very different levels of perfusion in different parts of the foot. SPP addresses the limitations of other tests:
- ABI limitations: Macrocirculatory tests alone can significantly misdiagnose PAD or under-diagnose disease severity in diabetic patients due to arterial calcification.
- TcPO2 contraindication: Cannot be performed on plantar foot due to thick skin/callus. Diabetic foot ulcers are usually plantar, and the posterior tibial artery (most likely to occlude) supplies this area.
- SPP advantage: No anatomical restrictions. Can test any angiosome including plantar foot for complete assessment.