1
|
Ud-Din S, Bayat A. Non-invasive objective devices for monitoring the inflammatory, proliferative and remodelling phases of cutaneous wound healing and skin scarring. Exp Dermatol 2016; 25:579-85. [DOI: 10.1111/exd.13027] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 12/29/2022]
Affiliation(s)
- Sara Ud-Din
- Plastic and Reconstructive Surgery Research; Institute of Inflammation and Repair; University of Manchester; Manchester UK
- University Hospital of South Manchester NHS Foundation Trust; Faculty of Medical and Human Sciences; Manchester Academic Health Science Centre; University of Manchester; Manchester UK
| | - Ardeshir Bayat
- Plastic and Reconstructive Surgery Research; Institute of Inflammation and Repair; University of Manchester; Manchester UK
- University Hospital of South Manchester NHS Foundation Trust; Faculty of Medical and Human Sciences; Manchester Academic Health Science Centre; University of Manchester; Manchester UK
| |
Collapse
|
2
|
Altintas B, Altintas AA, Kraemer R, Sorg H, Vogt PM, Altintas MA. Acute effects of local cold therapy in superficial burns on pain, in vivo microcirculation, edema formation and histomorphology. Burns 2013; 40:915-21. [PMID: 24342123 DOI: 10.1016/j.burns.2013.11.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 11/23/2013] [Accepted: 11/24/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Local cold therapy for burns is generally recommended to relief pain and limit tissue damage, however, there is limited data of its physiological benefit. This study aimed to evaluate pathophysiological effects of cold therapy in superficial burn on microcirculation, edema formation, and histomorphology. METHODS In 12 volunteers (8f, 4m; aged 30.4±14.1 years) circumscribed superficial burn was induced on both hand back and either left untreated as control (control-group) or treated by local-cold-application (cold-treatment-group). Prior to burn (t0), immediately (t1), 15 min (t2), and 30 min (t3) following cold therapy, following parameter was evaluated using intravital-microscopy; epidermal-thickness (ET), granular-cell-size (GCS), individual-blood-cell-flow (IBCF), and functional-capillary-density (FCD). RESULTS Both ET and GCS increased significantly more in control-group and slightly in cold-treatment-group in t1, while turns to insignificant t2 onwards. IBCF and FCD raised up in control-group compared to dramatically decrease in cold-treatment-group in t1. In t2 both parameter remains in control-group and increased in cold-treatment-group. Comparison of both groups for IBCF and FCD indicates significant difference in t1 and t2, however, insignificant in t0 and t3. CONCLUSIONS Microcirculation, edema formation, and histomorphology of superficial burn has been significantly influenced through immediate cold therapy, however, this alterations are transient and turns to ineffective after 30 min.
Collapse
Affiliation(s)
- B Altintas
- Medical School Hannover, Hannover 30625, Germany.
| | - A A Altintas
- Department of Hand-, Plastic- and Microsurgery, Friederikenstift Hospital Hannover, Humboldtstraße 5, Hannover 30169, Germany
| | - R Kraemer
- Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Hannover 30625, Germany
| | - H Sorg
- Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Hannover 30625, Germany
| | - P M Vogt
- Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Hannover 30625, Germany
| | - M A Altintas
- Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Hannover 30625, Germany
| |
Collapse
|
3
|
Böhling A, Bielfeldt S, Himmelmann A, Keskin M, Wilhelm KP. Comparison of the stratum corneum thickness measuredin vivowith confocal Raman spectroscopy and confocal reflectance microscopy. Skin Res Technol 2013; 20:50-7. [DOI: 10.1111/srt.12082] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2013] [Indexed: 11/29/2022]
Affiliation(s)
- A. Böhling
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - S. Bielfeldt
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - A. Himmelmann
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - M. Keskin
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| | - K.-P. Wilhelm
- proDERM Institute for Applied Dermatological Research GmbH; Schenefeld/Hamburg Germany
| |
Collapse
|
4
|
Lange-Asschenfeldt S, Bob A, Terhorst D, Ulrich M, Fluhr J, Mendez G, Roewert-Huber HJ, Stockfleth E, Lange-Asschenfeldt B. Applicability of confocal laser scanning microscopy for evaluation and monitoring of cutaneous wound healing. JOURNAL OF BIOMEDICAL OPTICS 2012; 17:076016. [PMID: 22894499 DOI: 10.1117/1.jbo.17.7.076016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
There is a high demand for noninvasive imaging techniques for wound assessment. In vivo reflectance confocal laser scanning microscopy (CLSM) represents an innovative optical technique for noninvasive evaluation of normal and diseased skin in vivo at near cellular resolution. This study was designed to test the feasibility of CLSM for noninvasive analysis of cutaneous wound healing in 15 patients (7 male/8 female), including acute and chronic, superficial and deep dermal skin wounds. A commercially available CLSM system was used for the assessment of wound bed and wound margins in order to obtain descriptive cellular and morphological parameters of cutaneous wound repair noninvasively and over time. CLSM was able to visualize features of cutaneous wound repair in epidermal and superficial dermal wounds, including aspects of inflammation, neovascularisation, and tissue remodelling in vivo. Limitations include the lack of mechanic fixation of the optical system on moist surfaces restricting the analysis of chronic skin wounds to the wound margins, as well as a limited optical resolution in areas of significant slough formation. By describing CLSM features of cutaneous inflammation, vascularisation, and epithelialisation, the findings of this study support the role of CLSM in modern wound research and management.
Collapse
Affiliation(s)
- Susanne Lange-Asschenfeldt
- Charité University Medicine Berlin, Department of Dermatology, Skin Cancer Center Charité, Universitätsmedizin Berlin, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Waring M, Bielfeldt S, Mätzold K, Wilhelm K, Butcher M. An evaluation of the skin stripping of wound dressing adhesives. J Wound Care 2011; 20:412, 414, 416-22. [DOI: 10.12968/jowc.2011.20.9.412] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - S. Bielfeldt
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany
| | - K. Mätzold
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany
| | - K.P. Wilhelm
- proDERM Institute for Applied Dermatological Research, Schenefeld/Hamburg, Germany
| | | |
Collapse
|
6
|
Gambichler T, Jaedicke V, Terras S. Optical coherence tomography in dermatology: technical and clinical aspects. Arch Dermatol Res 2011; 303:457-73. [DOI: 10.1007/s00403-011-1152-x] [Citation(s) in RCA: 171] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2011] [Revised: 05/04/2011] [Accepted: 05/19/2011] [Indexed: 11/24/2022]
|
7
|
Altintas AA, Stasch T, Oezcelik A, Altintas MA. In vivo comparison of microcirculation and histomorphology of two different flap donor sites. Microsc Res Tech 2011; 74:308-13. [DOI: 10.1002/jemt.20906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/14/2010] [Indexed: 11/09/2022]
Affiliation(s)
- Ahmet Ali Altintas
- Department of Plastic and Reconstructive Surgery, University of Essen, 445122 Essen, Germany
| | - Tilman Stasch
- Department of Plastic Surgery, University of Witten Herdecke, Campus Cologne, 51067 Cologne, Germany
| | - Arzu Oezcelik
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033
| | - Mehmet Ali Altintas
- Department of Plastic and Reconstructive Surgery, Medical School Hannover, 30625 Hannover, Germany
| |
Collapse
|
8
|
Altintas AA, Guggenheim M, Oezcelik A, Gehl B, Aust MC, Altintas MA. Local burn versus local cold induced acute effects on in vivo microcirculation and histomorphology of the human skin. Microsc Res Tech 2011; 74:963-9. [PMID: 21287657 DOI: 10.1002/jemt.20982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Accepted: 11/28/2010] [Indexed: 11/11/2022]
Abstract
BACKGROUND The impact of burns and colds on human skin microcirculation and histomorphology has not been compared as yet. Reflectance confocal microscopy (RCM) enables in vivo insight in human skin on cellular and subcellular levels. We evaluated analogies and differences of thermal injuries on microcirculation and histomorphology in vivo using RCM. METHODS Local superficial burn (6 female, 4 male; aged 28.4 ± 2.9 years, burn group) versus superficial cold (4 female, 6 male; aged 30.4 ± 5.2 years, cold group) was induced on the dorsum of the hand in an experimental immersion hand model. In vivo RCM was performed prior (control), immediately (t1) and 15 minutes (t2) following thermal injury to evaluate: Individual blood cell flow (IBCF), functional capillary density (FCD), epidermal thickness (ET), and granular cell size (GCS). RESULTS In the burn group, IBCF was increased at t1 (78.02 ± 2.60/min) and remained elevated at t2 (84.16 ± 3.04/min). In the cold group, IBCF decreased at t1 (12.62 ± 2.12 min) and increased at t2 (74.24 ± 3.14/min, P < 0.05) compared to the controls (58.23 ± 3.21/min). FCD was 6.74 ± 0.52/mm(2) in controls and increased at both t1 (7.82 ± 0.72/mm(2)) and t2 (8.02 ± 0.81/mm(2)) in the burn group. In the cold group, FCD decreased at t1 (2.60 ± 0.42/mm(2)) and increased at t2 (7.92 ± 0.44/mm(2), P < 0.05). ET increased at both t1 (43.12 ± 4.08 μm, P > 0.05) and t2 (47.26 ± 4.72 μm, P < 0.05) in the burn group. In the cold group, ET decreased at t1 (39.92 ± 3.14 μm, P > 0.05) and increased at t2 (44.72 ± 4.06 μm, P < 0.05) compared to the controls (41.26 ± 3.82 μm). Control GCS was 726.9 ± 59.4 μm(2) and increased at both t1 (739.8 ± 69.8 μm(2), P > 0.05) and t2 (762.6 ± 71.4 μm(2), P < 0.05) in the burn group. In the cold group, GCS decreased at t1 (712.4 ± 53.8 μm(2), P > 0.05) and increased at t2 (742.6 ± 64.8 μm(2), P < 0.05). CONCLUSIONS Superficial burn induces more cellular destruction and cold leads to huge fluctuation in tissue perfusion, however, with moderate impact on histomorphology. The effect on dermal capillaries suggests a selective neural control and cold injuries might down-regulate this system, much more than burns can activate it.
Collapse
Affiliation(s)
- Ahmet Ali Altintas
- Department of Plastic and Reconstructive Surgery, University of Essen, Essen, Germany.
| | | | | | | | | | | |
Collapse
|
9
|
In vivo reflectance-mode confocal microscopy provides insights in human skin microcirculation and histomorphology. Comput Med Imaging Graph 2009; 33:532-6. [DOI: 10.1016/j.compmedimag.2009.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 04/17/2009] [Accepted: 04/20/2009] [Indexed: 11/19/2022]
|
10
|
Altintas AA, Amini P, Altintas MA, Perbix W, Phan V, Stasch T, Spilker G. Histometric and histomorphologic comparison of combustion and ambustion using in vivo reflectance-confocal microscopy. Microsc Res Tech 2009; 73:160-4. [PMID: 19725063 DOI: 10.1002/jemt.20770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND When combustion and ambustion induce a superficial injury, they are summarized as superficial burns, regardless of the underlying cause. Reflectance-confocal microscopy (RCM) allows noninvasive imaging of the human skin on morphological features. We hypothesized that combustion and ambustion have different histomorphological effects on the human skin. METHODS Superficial burns caused by combustion (CO-group, five females, three males; aged 26.8 +/- 14.2 years) and caused by ambustion (AM-group, four females, four males; aged 28.1 +/- 13.8 years) were evaluated 24 h after injury. The following parameters were obtained using RCM on injured and noninjured (control) site: horny layer thickness, epidermal thickness, granular cell size, basal layer thickness. RESULTS Compared with the controls (12.8 +/- 2.5 microm), horny layer thickness decreased significantly to 10.6 +/- 2.1 microm in the CO-group, whereas it increased significantly to 17.8 +/- 2.8 microm in the AM-group. The epidermal thickness did not differ significantly in CO-group (47.9 +/- 2.1 microm) and AM-group (49.0 +/- 3.1 microm), however, both increased significantly compared with the controls (42.7 +/- 1.6 microm). The basal layer thickness increased more in AM-group (17.0 +/- 1.2 microm) compared to CO-group (15.4 +/- 1.1 microm). Both differed significantly compared with their controls (13.9 +/- 0.9 microm). The granular cell size increased significantly in both groups compared to the controls (721 +/- 42 microm), however, a significantly higher increase was observed in CO-group compared to AM-group (871 +/- 55 microm vs. 831 +/- 51 microm). CONCLUSIONS RCM evaluates significant histomorphological differences in superficial burns caused by combustion and ambustion. The term "superficial burn" should consider the underlying cause and thus supplemented by the term "combustion" or "ambustion."
Collapse
Affiliation(s)
- Ahmet Ali Altintas
- Department of Plastic and Reconstructive Surgery, Cologne-Merheim University of Witten-Herdecke, Cologne, Germany
| | | | | | | | | | | | | |
Collapse
|
11
|
Altintas MA, Altintas AA, Guggenheim M, Steiert AE, Aust MC, Niederbichler AD, Herold C, Vogt PM. Insight in human skin microcirculation using in vivo reflectance-mode confocal laser scanning microscopy. J Digit Imaging 2009; 23:475-81. [PMID: 19513794 DOI: 10.1007/s10278-009-9219-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2009] [Revised: 04/14/2009] [Accepted: 05/02/2009] [Indexed: 10/20/2022] Open
Abstract
Reflectance-mode confocal laser scanning microscopy allows in vivo imaging of the human skin. We hypothesized that this high-resolution technique enables observation of dynamic changes of the cutaneous microcirculation. Twenty-two volunteers were randomly divided in two groups. Group 1 was exposed to local heating and group 2 to local cold stress. Confocal microscopy was performed prior t (0) (control), directly t (1) and 5 min t (2) after local temperature changes to evaluate quantitative blood cell flow, capillary loop diameter, and density of dermal capillaries. In group 1, blood flow increased at t (1) (75.82 +/- 2.86/min) and further at t (2) (84.09 +/- 3.39/min) compared to the control (61.09 +/- 3.21/min). The control capillary size was 9.59 +/- 0.25 microm, increased to 11.16 +/- 0.21 microm (t (1)) and 11.57 +/- 0.24 microm (t (2)). The dermal capillary density increased in t (1) (7.26 +/- 0.76/mm(2)) and t (2) (8.16 +/- 0.52/mm(2)), compared to the control (7.04 +/- 0.62/mm(2)). In group 2, blood flow decreased at t (1) (41.73 +/- 2.61/min) and increased at t (2) (83.27 +/- 3.29/min) compared to the control (60.73 +/- 2.90/min). The control capillary size was 9.55 +/- 0.25 microm, decreased at t (1) (7.78 +/- 0.26 microm) and increased at t (2) (11.38 +/- 0.26 microm). Capillary density decreased at t (1) (5.01 +/- 0.49/mm(2)) and increased at t (2) (7.28 +/- 0.53/mm(2)) compared to the control (7.01 +/- 0.52/mm(2)). Confocal microscopy is a sensitive and noninvasive imaging tool for characterizing and quantifying dynamic changes of cutaneous microcirculation on a histomorphological level.
Collapse
Affiliation(s)
- Mehmet Ali Altintas
- Department of Plastic, Hand and Reconstructive Surgery, Medical School Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | | | | | | | | | | | | | | |
Collapse
|