title: Assessment of microcirculatory influence on cellular morphology in human burn wound healing using reflectance-mode-confocal microscopy.
abstract: 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.
authors.affiliation: Department of Hand, Plastic and Reconstructive Surgery, Burn Center Cologne, University of Witten Campus Cologne Merheim, 51109 Cologne, Germany. draltintas@gmail.com
authors.forename: Ahmet Ali
authors.initials: AA
authors.lastname: Altintas
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Altintas
authors.forename: Kyros
authors.initials: K
authors.lastname: Ipaktchi
authors.forename: Merlin
authors.initials: M
authors.lastname: Guggenheim
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Theodorou
authors.forename: Pauangiotis
authors.initials: P
authors.lastname: Theodorou
authors.forename: Peymaneh
authors.initials: P
authors.lastname: Amini
authors.forename: Gerald
authors.initials: G
authors.lastname: Spilker
mesh_terms: 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