Skin blood flow pattern in burns outcomes.
Functional microcirculatory aspects of burned sites were examined including areas of self-healed burns, and grafted areas. Donor areas were also examined. In 10 patients with burns in the lower limbs, both self-healed and with grafts, the microcirculatory response was evaluated by Laser Doppler flowmetry (LDF) measuring for each site the resting flux at 36 degrees, the postural venular-arteriolar reflex (VAR) and the flux at 41 degrees (heating). The first evaluation was carried out on discharge, and subsequently at approximately 45 day intervals during uniform therapy follow-up (elastocompression). The burn-affected area (self-healed, graft) and those donor areas present should increase resting flux by comparison with control areas. This was particularly so in the self-healed burn, which does however tend to converge in time towards control values. Response to stress tests (VAR and heating) presents percentage variations similar to normal skin in the various areas, with the exception of the grafted areas which present a reduced response in the 1st weeks following engraftment. No significant differences in response to heating were detected. It can be suggested that these differences are due to anatomic variations in revascularization and healing in the different areas as well as to alterations in microvascular innervation and local response to vasoactive substances.
Barachini
P
P
Department of Dermatology, Burn Center, University of Pisa, Vir Roma 67, 56126 Pisa, Italy. segr-dermo@med.unipi.it
Vezzoni
G M
GM
Palombo
C
C
Franzoni
F
F
Bigalli
G
G
D000328:Adult; D000704:Analysis of Variance; D001160:Arterioles / Q000503:physiopathology; D002056:Burns / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation; D014666:Vasomotor System / Q000503:physiopathology; D014699:Venules / Q000503:physiopathology; D014945:Wound Healing