title: A new in vivo model using a dorsal skinfold chamber to investigate microcirculation and angiogenesis in diabetic wounds.
abstract: BACKGROUND
  Diabetes mellitus describes a dysregulation of glucose metabolism due to improper insulin secretion, reduced insulin efficacy or both. It is a well-known fact that diabetic patients are likely to suffer from impaired wound healing, as diabetes strongly affects tissue angiogenesis. Until now, no satisfying in vivo murine model has been established to analyze the dynamics of angiogenesis during diabetic wound healing. To help understand the pathophysiology of diabetes and its effect on angiogenesis, a novel in vivo murine model was established using the skinfold chamber in mice.
  
  
  METHODS
  Mutant diabetic mice (db; BKS.Cg-m+/+Lepr (db) /J), wildtype mice (dock7Lepr (db) +/+m) and laboratory BALB/c mice were examined. They were kept in single cages with access to laboratory chow with an 12/12 hour day/night circle. Lesions of the panniculus muscle (Ø 2 mm) were created in the center of the transparent window chamber and the subsequent muscular wound healing was then observed for a period of 22 days. Important analytic parameters included vessel diameter, red blood cell velocity, vascular permeability, and leakage of muscle capillaries and post capillary venules. The key parameters were functional capillary density (FCD) and angiogenesis positive area (APA).
  
  
  RESULTS
  We established a model which allows high resolution in vivo imaging of functional angiogenesis in diabetic wounds. As expected, db mice showed impaired wound closure (day 22) compared to wounds of BALB/c or WT mice (day 15). FCD was lower in diabetic mice compared to WT and BALB/c during the entire observation period. The dynamics of angiogenesis also decreased in db mice, as reflected by the lowest APA levels. Significant variations in the skin buildup were observed, with the greatest skin depth in db mice. Furthermore, in db mice, the dermis:subcutaneous ratio was highly shifted towards the subcutaneous layers as opposed to WT or BALB/c mice.
  
  
  CONCLUSIONS
  Using this new in vivo model of the skinfold chamber, it was possible to analyze and quantify microangiopathical changes which are essential for a better understanding of the pathophysiology of disturbed wound healing. Research in microcirculation is important to display perfusion in wounds versus healthy tissue. Using our model, we were able to compare wound healing in diabetic and healthy mice. We were also able to objectively analyze perfusion in wound edges and compare microcirculatory parameters. This model may be well suited to augment different therapeutic options.
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Langer
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Beescho
authors.affiliation: Department of Plastic Surgery and Severe Burns, University Hospital Bergmannsheil, Ruhr University Bochum, Germany.
authors.forename: Andrej
authors.initials: A
authors.lastname: Ring
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Olivia
authors.initials: O
authors.lastname: Dorfmann
authors.affiliation: Department of Trauma, University Hospital Essen, Germany.
authors.forename: Hans Ulrich
authors.initials: HU
authors.lastname: Steinau
authors.affiliation: Department of Plastic, Esthetic and Special Hand Surgery, University Hospital Leipzig, Germany.
authors.forename: Nick
authors.initials: N
authors.lastname: Spindler
keywords: angiogenesis; diabetic wounds; microcirculation; skinfold chamber