A descriptive study of skin temperature, tissue perfusion, and tissue oxygen in patients with chronic venous disease

Abstract

Chronic inflammation and microcirculatory disturbances of the skin have been implicated as causative factors of complications associated with chronic venous disease (CVD). The purpose of this study is to describe the mean differences between and correlations among three measures of microcirculation: skin temperature (Tsk), tissue perfusion/blood flow (BF), and tissue oxygen (tcPO(2)) of CVD-inflamed skin compared to normal controls. In a convenience sample of 55 patients with CVD (n = 31) and without CVD (n = 24), Tsk was measured with an infrared thermometer, BF with a laser Doppler flowmeter, and tcPO( 2) with a transcutaneous oximeter across three measurements periods 1 week apart (Times 1, 2, and 3) at the medial aspect of both lower legs. Tsk was higher (1.2 degrees C) across all measurement periods (p < .05), BF was higher at Times 1 and 3 (p = .002 and .012, respectively), and tcPO(2) was lower at Times 1 and 3 (p = .013 and .050, respectively) in the CVD group as compared to the non-CVD group. BF and Tsk were positively correlated at Times 1 and 2 (r = .516, p < .005; r = 0.278, p = .04) but not at Time 3 (r = 0.235, p > .05). No consistently significant correlations were found between tcPO(2) and BF or tcPO(2) and Tsk (p > .05). Tsk and BF were higher in the skin of lower legs affected by CVD than in those not affected. Pathological processes in the skin produce heat detectable by an infrared thermometer. Measurement and monitoring of Tsk can augment clinical findings and guide treatment when localized inflammation is suspected. Future studies of Tsk should be directed toward the usefulness of infrared technology to develop a CVD leg ulcer prediction model.