Objective Clinical assessments and laser Doppler perfusion measurements (LDPM) of skin microcirculation have limited value, as they fail to capture events regulated by local metabolic needs at a papillary capillary level. This study aimed to examine the ability of computer‐assisted video microscopy (CAVM) and diffuse reflectance spectroscopy (DRS) to assess skin nutritive perfusion—compared to LDPM. Methods Healthy volunteers (n = 10) were examined after (≈1 and ≈24 h) an incision (5 × 1 mm) on the forearm, at 0.1 mm (only with CAVM), 2−3 mm, and 30 mm from the trauma. Results No changes were detected by CAVM after ≈1 h. After ≈24 h, 0−1 mm from the trauma, both CAVM parameters were increased: functional capillary density (capillary crossings/mm, 11.8 ± 1.4 vs. 7.3 ± 1.2, p < .01) and capillary flow velocities (CFV, %capillaries with brisk flow, 10 ± 6.8 vs. 1 ± 1, p < .01). At a distance of 2−3 mm, only CFV was increased (6.2 ± 6.1 vs. 1 ± 1, p < .05). DRS and LDPM measurements increased 2−3 mm from the trauma line in relation to baseline after both ≈1 and ≈24 h, that is, with DRS (%microvascular oxygen saturation): 45.8 ± 7.4% (baseline), 70.0 ± 12.5% (≈1 h), and 73.1 ± 10.4% (≈24 h), p < .01 and with LDPM (a.u.): 7.2 ± 2.5 (baseline), 28.3 ± 18.7 (≈1 h), and 45.9 ± 16.3 (≈24 h), p < .01. Conclusions ≈24 h after skin trauma, an increased function of the nutritive papillary capillaries can be detected by CAVM.
Remodeling of tissue is a way of maintaining homeostasis in response to physiological and pathological stimuli such as aging, disease, and injury. 1 Microscopy (electron and light) of skin biopsies has been used to visualize human microvascular anatomy, 2 and microvascular remodeling has been studied in animal models and computer simulation. 3 To capture dynamic processes, other methods are needed-for example, in vivo microscopy.Healing of a skin trauma leads to an increase in local metabolic rate for proliferation of cells and production of extracellular matrix. Because of poor diffusion capacity of O 2 in human tissues, the maximal O 2 diffusion distance from a perfused capillary
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