Objective perfusion targets for wound healing (toe pressure, TcPO2, SPP) and their use
Applied
Type
AdditionConfidence
95%
Created
Mar 19, 2026
Evidence
1 source
Rationale
The integration of the 2025 ACC Scientific Statement provides updated, high-level evidence specifically addressing the diabetic population, where standard non-invasive testing like ABI is often compromised by medial arterial calcification. This addition strengthens the clinical utility of TP and TcPO2 as primary perfusion targets in this high-risk cohort. All abbreviations were expanded on first use as per instructions.
Evidence
Content Changes
removedadded
Objective perfusion measurements are essential for assessing tissue viability and guiding revascularization in chronic limb-threatening ischemia (CLTI). Toe pressure (TP) <30 mmHg or transcutaneous oxygen tension (TcPO₂) <25–30 mmHg indicates critical ischemia with low likelihood of wound healing without revascularization.revascularization [@conte2019]. In patients with diabetes, the 2025 ACC scientific statement emphasizes that TP and TcPO₂ are more reliable diagnostic tools than the ankle-brachial index (ABI), which may be falsely elevated due to medial arterial calcification (MAC) [@acc2025-h]. Skin perfusion pressure (SPP) <30–40 mmHg similarly predicts poor healing. These thresholds should be used to establish hemodynamic targets for revascularization and to reassess nonhealing wounds after intervention [@conte2019].[@conte2019; @acc2025-h].