Assessment of microcirculatory influence on cellular morphology in human burn wound healing using reflectance-mode-confocal microscopy.
Previous studies have assessed the effects of changes in microcirculation on wound healing; however, the influence of microcirculation on tissue histomorphology remains widely unknown. Reflectance-mode-confocal microscopy (RMCM) enables in vivo tissue observation on a cellular level. We present RMCM data evaluating the local microcirculation and assess the influence on histomorphology during burn healing. RMCM was performed in 12 patients (aged; 36.2+/-14.2 years, maximum-burn-extent: 4% total body surface area) at times 12, 36, and 72 hours after a superficial burn. The following parameters were assessed: quantitative blood-cell-flow (cbf), epidermal thickness (Emin), basal-layer thickness (tbl), and granular cell-size (Agran). Cbf was found to be 54+/-3.6 cells/minutes (control), increased to 91+/-3.6 cells/minutes (p<0.05) 12 hours postburn; decreased to 71+/-6.1 cells/minutes (p<0.05) (36 hours), and to 63+/-2.3 cells/minutes (p>0.05) 72 hours postburn. Emin was 43.74+/-3.87 mum (control), increased to 51.67+/-4.04 mum (p<0.05) 12 hours, decreased to 48.67+/-3.51 mum (p<0.05) 36 hours, and to 45.33+/-3.21 mum (p>0.05) at 72 hours postburn. Tbl was 14.17+/-0.6 mum (control), increased to 16.93+/-1.15 mum (p<0.05) 12 hours, decreased to 15.93+/-1.20 mum (p<0.05) 32 hours, and to 15.00+/-0.85 mum (p>0.05) 72 hours postburn. Agran was 718+/-56.20 mum(2) (control), increased to 901+/-66.02 mum(2) (p<0.05) 12 hours, decreased to 826+/-56.86 mum(2) 36 hours, and 766+/-65.06 mum(2) at 72 hours postburn. RMCM enables in vivo observation of wound microcirculation and allows direct assessment of vascular effects on cutaneous histomorphology during the healing course of superficial burns.
Altintas
Ahmet Ali
AA
Department of Hand, Plastic and Reconstructive Surgery, Burn Center Cologne, University of Witten Campus Cologne Merheim, 51109 Cologne, Germany. draltintas@gmail.com
Altintas
Mehmet Ali
MA
Ipaktchi
Kyros
K
Guggenheim
Merlin
M
Theodorou
Panagiotis
P
Theodorou
Pauangiotis
P
Amini
Peymaneh
P
Spilker
Gerald
G
D000328:Adult; D002056:Burns / Q000473:pathology*; D016022:Case-Control Studies; D020405:Dermis / Q000098:blood supply* / Q000473:pathology*; D004817:Epidermis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D018613:Microscopy, Confocal; D008875:Middle Aged; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult