title: Impact of diabetes and peripheral arterial occlusive disease on the functional microcirculation at the plantar foot.
abstract: BACKGROUND
  Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive wound infections of the feet as complications in patients with diabetes and/or peripheral arterial occlusive disease (PAOD). Microcirculatory changes seem to play an important role. However, the evaluation of functional changes in the soft tissue microcirculation at the plantar foot using combined Laser-Doppler and Photospectrometry System has not yet been performed in patients with DM or PAOD.
  
  
  METHODS
  A prospective, controlled cohort study was designed consisting of a total of 107 subjects allocated to 1 of 3 groups-group A: healthy subjects (57% males, 63.3 y); group B: patients with diabetes mellitus (DM) (53% males, 59.4 y); and group C: patients with PAOD (81% males, 66.1 y). Microcirculatory data were assessed using a combined Laser-Doppler and Photospectrometry System.
  
  
  RESULTS
  Global cutaneous oxygen saturation microcirculation at the plantar foot of healthy individuals was 8.4% higher than in patients with DM and 8.1% higher than in patients with PAOD (both P = 0.033). Patients with diabetes did not show significant differences in global cutaneous blood flow when compared with either healthy subjects or patients suffering from PAOD.
  
  
  CONCLUSIONS
  Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD.
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Kabbani
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Rotter
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Busche
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Waldemar
authors.initials: W
authors.lastname: Wuerfel
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Jokuszies
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Knobloch
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Vogt
authors.affiliation: Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Kraemer