title: Active skin perfusion and thermoregulatory response in the hand following nerve injury and repair in human upper extremities.
abstract: Cutaneous vasoconstriction/vasodilatation occurs in response to whole body and local cooling/heating, and the vasomotor activities play a pivotal role in thermal control of the human body. The mechanisms underlying regulation of skin blood flow involve both neurogenic and humeral/local chemical influence, contributing to the initial response to thermal stimuli and the prolonged phase of response, respectively. Previous studies have suggested the impairment of cutaneous thermal regulation after nerve injury. However, the evidence regarding how the skin perfusion and thermoregulatory response evolve after nerve injury and repair remains limited. Here we observed, by utilizing laser-Doppler perfusion imaging, baseline skin perfusion and perfusion change in response to thermal stimuli after median and ulnar nerve injury, and the results showed that baseline perfusion in autonomous skin area profoundly decreased and active rewarming after clod stress dramatically diminished before sensory recovery of the skin became detectable. In addition, baseline cutaneous perfusion was recovered as the skin regained touch sensation, and exhibited positive correlation to touch sensibility of the skin. These data indicate that both active perfusion and thermoregulatory response of the skin are markedly compromised during skin denervation and can be recovered by re-innervation. This suggests the importance of timely repair of injured nerve, especially in the practice of replantation.
authors.affiliation: Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, PR China.
authors.forename: Aidong
authors.initials: A
authors.lastname: Deng
authors.affiliation: Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, PR China.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, PR China.
authors.forename: Chen
authors.initials: C
authors.lastname: Gu
authors.affiliation: Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China.
authors.forename: Xiaosong
authors.initials: X
authors.lastname: Gu
authors.affiliation: Department of Hand Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu 226001, PR China. Electronic address: 13809081785@163.com.
authors.forename: Jianhui
authors.initials: J
authors.lastname: Gu
authors.affiliation: Jiangsu Key Laboratory of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China; Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu 226001, PR China. Electronic address: hoo@ntu.edu.cn.
authors.forename: Wen
authors.initials: W
authors.lastname: Hu
mesh_terms: D000328:Adult; D001833:Body Temperature Regulation / Q000502:physiology*; D005260:Female; D006225:Hand / Q000098:blood supply* / Q000294:innervation / Q000502:physiology; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008475:Median Nerve / Q000293:injuries*; D008875:Middle Aged; D012018:Reflex / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology*; D012867:Skin / Q000098:blood supply* / Q000294:innervation; D013312:Stress, Physiological / Q000502:physiology; D014110:Touch / Q000502:physiology; D014459:Ulnar Nerve / Q000293:injuries*; D055815:Young Adult
keywords: Laser-Doppler perfusion imaging; Median nerve; Nerve injury; Skin perfusion; Ulnar nerve; Vasomotor control