Cutaneous Microcirculation of the Foot

Abstract

The skin, the body’s largest organ, acts as a shield against infections and injuries. The skin has an inherent ability to autoregulate its blood flow, which depends on extrinsic/intrinsic factors. This function is facilitated by a complex regulatory system that includes local regulation of cutanemicrocirculation involving sensory and autonomic fibres. These play important roles in thermoregulation, maintenance of homeostasis, defence, inflammatory response and nutrition. Any structural or functional damage to the microvasculature can lead to an incongruity in the demand and supply either due to physiological or pathological reasons. Besides, the small fibre nerves supplied by the microvessels can suffer from hypoxia, which in turn can cause problems. By understanding these functional aspects and applying this knowledge for assessment, the complex pathophysiological mechanisms of diseases like Raynaud’s and diabetic-foot complications can be better understood. Moreover, microcirculation is crucial for wound healing in both diabetic foot and in pressure ulcers. This chapter aims to discuss the anatomy and physiology of foot microcirculation and its involvement in the pathobiology of certain diseases. Furthermore, various microcirculatory assessment tools and methods are discussed. Acquiring this knowledge can be helpful in providing more effective prevention, diagnosis, and treatment of microcirculatory diseases of the foot.