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Wound Care Tests Explained: ABI, TBI, and TCOM

If you have a non-healing wound, chronic wound, diabetic foot ulcer, or leg ulcer, your doctor may recommend ABI, TBI, and TCOM as part of a complete wound assessment. These tests help evaluate blood flow and oxygen supply to the affected tissue, which are key factors in wound healing.

When circulation is poor or oxygen delivery is low, even a small wound may heal slowly or become more difficult to treat. By identifying these hidden problems, doctors can better understand the cause of delayed healing and plan more targeted wound care.

 

Why are these wound care tests needed?

For a wound to heal, the body needs:
  • Good blood flow
  • Enough oxygen
  • Healthy surrounding tissue
  • The right treatment plan
If circulation is poor, even good wound dressings and infection control may not be enough. A wound may heal very slowly, keep coming back, or get worse over time.
That is why wound care investigations are important. They help answer key questions:
  • Is enough blood reaching the wound?
  • Is poor circulation delaying healing?
  • Is the tissue getting enough oxygen?
  • Does the wound have a good chance of healing?
  • Is more advanced treatment needed?



What is ABI?

ABI stands for Ankle-Brachial Index.
This is a simple test that compares the blood pressure in your ankle with the blood pressure in your arm. It helps doctors see whether blood is flowing properly through the legs.
In simple terms:

An ABI test helps check for poor circulation in the legs.
 
Wound-Care-Tests-Explained-ABI,-TBI,-and-TCOM-2-image-1.png

Why ABI matters in wound care

  • Helps detect reduced blood flow in the lower limbs
  • Can show whether poor circulation is affecting wound healing
  • Often used for foot wounds, leg ulcers, and non-healing wounds
  • Helps doctors decide whether more vascular assessment is needed
 
 

What is TBI?

TBI stands for Toe-Brachial Index.
A TBI test is similar to ABI, but it measures blood pressure in the toe instead of the ankle. This is especially useful when doctors need a closer look at blood flow to the feet and toes.

In simple terms:
TBI checks how well blood is reaching the toes and feet.
 
Wound-Care-Tests-Explained-ABI,-TBI,-and-TCOM-2-image-2.png
 


Why TBI matters in wound care

  • Helpful in diabetic foot ulcer assessment
  • Useful for toe wounds and small foot wounds
  • Gives more information about circulation in the foot
  • Can help when ABI alone does not give the full picture
 

What is TCOM?

TCOM stands for Transcutaneous Oxygen Measurement.

A TCOM test measures how much oxygen is reaching the skin and tissue around a wound. This matters because wounds need oxygen to repair damaged tissue and heal properly.

In simple terms:
TCOM shows whether the wound area is getting enough oxygen to heal.
 
Wound-Care-Tests-Explained-ABI,-TBI,-and-TCOM-2-image-3.png



Why TCOM matters in wound care

  • Measures tissue oxygen
  • Helps assess wound healing potential
  • Shows whether the wound area has enough oxygen for repair
  • Supports planning for more advanced wound treatment when needed
 

ABI vs TBI vs TCOM: what is the difference?

These wound care tests are related, but each one looks at something different:
  • ABI checks blood flow in the legs
  • TBI checks blood flow in the toes and feet
  • TCOM checks oxygen reaching the tissue
Together, ABI, TBI, and TCOM help doctors understand why a wound is not healing and what kind of treatment may be needed next.
 
 

When might these tests be recommended?

Your doctor may recommend ABI, TBI, or TCOM if you have:
  • A non-healing wound
  • A chronic wound
  • A diabetic foot ulcer
  • A leg ulcer
  • A foot wound
  • Signs of poor circulation
  • Delayed wound healing despite treatment
 

Why this matters for patients

The most important thing to understand is that a wound is not always only a skin problem. Sometimes the real issue is hidden deeper in the body. If blood flow is poor or oxygen levels are too low, healing may be delayed no matter how carefully the wound is cleaned or dressed.
That is why ABI, TBI, and TCOM in wound care are so important. These tests help doctors look beyond the surface, find the cause of delayed healing, and choose the right treatment earlier.

At Bumrungrad Holistic Wound Care & Vascular Clinic, patients with chronic wounds, diabetic foot ulcers, leg ulcers, ischemic wounds, and non-healing wounds can receive comprehensive wound assessment and personalized care to identify the cause of delayed healing and support better healing outcomes.

 

FAQ

What is ABI in wound care?
ABI is a test that compares blood pressure in the ankle and arm to check blood flow in the legs.

What is the difference between ABI and TBI?
ABI measures blood pressure at the ankle, while TBI measures blood pressure at the toe. TBI helps assess circulation closer to the wound area in the foot.

What does TCOM measure?
TCOM measures how much oxygen is reaching the tissue around a wound.

Why are ABI, TBI, and TCOM important for non-healing wounds?
These tests help doctors find out whether poor circulation or low tissue oxygen is delaying wound healing.
 




 
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Last modify: May 12, 2026

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