The effect of contusion and cryotherapy on skeletal muscle microcirculation.
OBJECTIVE
The most common treatment of soft tissue contusions is ice application (cryotherapy). The physiological basis for this therapy is assumed to be cold-mediated vasoconstriction resulting in decreased edema formation and a reduction in overall morbidity. This proposed mechanism has not been tested. The present research examined the hypothesis that cryotherapy following contusion is effective because it reduces microvascular perfusion and subsequent edema formation.


METHODS
The microcirculatory responses to contusion were studied with and without cryotherapy in a chronically instrumented rat model. Initial studies evaluated the immediate effects of cryotherapy on arteriolar and venular diameters and microvascular perfusion (using laser Doppler floxmetry). Variables were measured before and immediately after 20 minutes of cryotherapy. Two additional studies monitored the same microvascular parameters longitudinally in four sets of chronically instrumented animals. Groups of rats studied had contusion or sham contusion with ice treatment or no ice treatment. Measurements were performed repeatedly before and after treatment for 24 hours or 96 hours after contusion/sham contusion.


RESULTS
The acute microvascular effects of cryotherapy were vasoconstriction and decreased perfusion. However, when cryotherapy was used as a treatment following contusion/sham contusion, there were no long-lasting microvascular effects of cryotherapy either in the presence or absence of contusion.


CONCLUSIONS
These results indicate that cryotherapy of striated muscle following contusion does not reduce microvascular diameters or decrease microvascular perfusion. Alternate mechanisms of action for cryotherapy treatment need to be investigated.
Curl
W W
WW
Department of Orthopaedic Surgery, Bowman Grey School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1070, USA.
Smith
B P
BP
Marr
A
A
Rosencrance
E
E
Holden
M
M
Smith
T L
TL
D000818:Animals; D001160:Arterioles / Q000473:pathology / Q000503:physiopathology; D003288:Contusions / Q000503:physiopathology* / Q000628:therapy; D017679:Cryotherapy; D004195:Disease Models, Animal; D004487:Edema / Q000517:prevention & control; D005069:Evaluation Studies as Topic; D007053:Ice; D017078:Laser-Doppler Flowmetry; D008137:Longitudinal Studies; D008833:Microcirculation / Q000473:pathology / Q000503:physiopathology; D008991:Monitoring, Physiologic; D018482:Muscle, Skeletal / Q000098:blood supply / Q000293:injuries*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow / Q000502:physiology; D017695:Soft Tissue Injuries / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors; D014661:Vasoconstriction; D014699:Venules / Q000473:pathology / Q000503:physiopathology
D007053:Ice