scholarly journals Patterns of Sensory and Autonomic Reinnervation of Long-Standing Myocutaneous Microvascular Flaps and Split-Skin Grafts Applied to Fascial Beds

2005 ◽  
Vol 13 (1) ◽  
pp. 16-22
Author(s):  
A Juma ◽  
D Oudit ◽  
M Ellabban
Keyword(s):  
Laser Doppler Flowmetry ◽  
Electrical Resistance ◽  
Laser Doppler ◽  
Lower Limbs ◽  
Autonomic Nerve ◽  
Skin Grafts ◽  
Doppler Flowmetry ◽  
Group A ◽  
Group B ◽  
Split Skin

Background: There is a paucity of reports in the literature examining the pattern of sensory and autonomic neural recovery of myocutaneous microvascular flaps and skin grafts to the lower limbs after a prolonged period of time. Objectives: To investigate the recovery of sensation and autonomic nerve activity in long-standing split-skin grafts applied to fascial beds and in myocutaneous microvascular flaps. Methods: The patients were divided into two groups: group a consisted of patients with a split-skin graft applied to a fascial bed (n=11) and group B consisted of patients with free microvascular flaps (n=4). Patients in both groups underwent various clinical subjective and objective tests, including the measurement of electrical resistance and thermal sensory analysis. Laser Doppler flowmetry was used to investigate the blood flow patterns. Results: Patients in both groups showed significantly reduced sensory modalities. However, the findings of both the electrical resistance and laser Doppler flowmetry were significantly different among the patients in group a compared with controls. In contrast, electrical resistance and laser Doppler flowmetry test results were similar in group B and controls. Conclusions: Both split-skin grafts applied to fascial beds and microvascular flaps on the lower limb had poor sensory recovery. However, after 15 years, the microvascular flaps regained the ability to sweat and some degree of thermoregulatory function. This may imply that the long-standing myocutaneous free flaps regained some aspects of their autonomic innervation, whereas the split-skin grafts had not.

scholarly journals Laser Doppler Flow Imaging of Open Lower Leg Fractures in an Animal Experimental Model

2002 ◽  
Vol 10 (2) ◽  
pp. 114-119 ◽  
Author(s):  
L Herzog ◽  
FX Huber ◽  
PJ Meeder ◽  
G Muhr ◽  
J Buchholz
Keyword(s):  
Experimental Model ◽  
Laser Doppler Flowmetry ◽  
Tibial Fracture ◽  
Muscle Flap ◽  
Lower Leg ◽  
Laser Doppler ◽  
Doppler Flowmetry ◽  
Group A ◽  
Group B ◽  
Animal Experimental Model

Purpose. Open lower leg fractures are frequently associated with severe soft tissue damage, followed by osteomyelitis. Using an animal experimental model, we investigated the effect of timing of coverage of a tibial fracture with a local muscle flap. Methods. 80 rabbits had a tibial fracture induced in a standardised fashion, which was stabilised by screw osteosynthesis. After 3 (group A; n=40) and 7 days (group B; n=40), respectively, the tissue defect was covered by a local gastrocnemius flap. In increasing intervals from 1 to 2, 4, 8, and 16 weeks, the rabbits from each group were killed and the bone fracture was analysed histomorphologically Cortical microcirculation was measured by 2-channel laser doppler flowmetry. Results. Muscle flaps after 3 days improved perfusion significantly as compared with 7 days (24 Flux [standard error, 5 Flux] versus 10 Flux [3 Flux]; baseline, 1.4 Flux). Group A animals also displayed a lower rate of necrosis (0 versus 38). The incidence of osteomyelitis was higher in group B than in group A (24% versus 0%). Conclusion. Laser doppler flowmetry was proven to be a reliable, minimally invasive means for identifying avital tissue, leading to reduction in the loss of vital bone tissue in experimental settings.

scholarly journals Patterns of Reinnervation and Blood Flow in Split-Skin Grafts

2005 ◽  
Vol 13 (3) ◽  
pp. 133-137
Author(s):  
A Juma ◽  
D Oudit ◽  
M Ellabban
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Normal Skin ◽  
Laser Doppler ◽  
Skin Grafts ◽  
Nerve Fibres ◽  
Doppler Flowmetry ◽  
Protein Gene Product ◽  
Split Skin ◽  
Von Willebrand

One of the most important functions of skin is thermoregulation. The alterations in the patterns of blood flow in skin is one of the main physiological processes responsible for thermoregulatory control. The mechanisms governing the thermoregulatory control of cutaneous blood flow are mainly neural and chemical in nature. At present, there is a lack of studies in the literature looking at the relationship between reinnervation and the blood flow pattern of skin grafts. The present study uses Laser Doppler flowmetry and the immunohistochemical stains protein gene product 9.5, calcitonin gene-related peptide and substance P to identify nerve fibres, and antibodies to CD31 and von Willebrand factor to identify endothelial tissues. The aim of the present study was to investigate the patterns of blood flow and nerve tissue regeneration in split-skin grafts up to 15 years following the original procedure. Thirty-two split-skin grafts were studied and these were placed into two groups based on the nature of the bed of excision: group I consisted of patients who underwent tangential excision and split-skin grafting (n=17), and group II consisted of patients with split-skin grafts placed onto fascial beds (n=15). Each subpopulation of patients was further divided into three groups based on the length of time following grafting: one to three years, four to six years and seven to 15 years. These divisions were arbitrarily chosen and called A1, A2 and A3, respectively. In the Laser Doppler flowmetry arm of the study, the grafts were assessed at various stages after heating, cooling and further reheating. The Laser Doppler flowmetry studies showed that, on subjecting the skin grafts in both groups I and II to heating and cooling followed by reheating, the overall response of the blood flow to changes in the temperature was slower. The immunohistochemical analysis showed that in all graft types and graft ages, protein gene product 9.5, calcitonin gene-related peptide and substance P stains demonstrated a relative lack of the presence of nerve fibres in the split-skin grafts compared with the control (‘normal’ skin). However, von Willebrand factor and CD31 immunological staining demonstrated that vessels were present in the split-skin grafts, with no significant difference in size or quantity from the control samples. It was found that the blood flow in the split-skin graft in response to thermal challenge, although present, was slower than that of normal skin, a finding which was independent of the age of the skin graft. It is thought that this was related to a lack of regeneration of nerve fibres and, hence, a deficiency in the neurally mediated reflexes of the blood vessels within the split-skin grafts.

Vascular Assessment in Patients With a Lower Limb Wound: A Correlational Study of Photoplethysmography and Laser Doppler Flowmetry Toe Pressure Techniques

2020 ◽  
pp. 193229682097997
Author(s):  
Jérôme Patry ◽  
Louis Laurencelle ◽  
Justine Bélisle ◽  
Maryse Beaumier
Keyword(s):  
Laser Doppler Flowmetry ◽  
Pressure Measurement ◽  
Lower Limb ◽  
Laser Doppler ◽  
Lower Limbs ◽  
Correlational Study ◽  
Care Clinic ◽  
Doppler Flowmetry ◽  
Vascular Assessment ◽  
Toe Pressure

Background: Vascular assessment of the lower limbs is essential in patients with diabetes. In the presence of noncompressible arteries, the ankle brachial index (ABI) can either be inconclusive or provide false-positive results. Toe pressure measurement has been suggested as an alternative as a noninvasive method for detecting peripheral arterial disease (PAD). Toe pressure measurement can be performed either by photoplethysmography (PPG) or by Laser Doppler flowmetry (LDF). The aim of this study was to determine correlations between the two techniques in order to promote the use of PPG in clinical practice. Methods: This was a prospective correlational study of 108 consecutive recruited adult patients, with and without diabetes, with at least one lower limb wound from a University-affiliated hospital wound care clinic. Toe pressure measurements were both performed with PPG and LDF devices. Results: Mean toe pressure values for PPG and LDF were, respectively, 83.7 (SD 35.4) and 79.5 (SD 32.0) mmHg (with a paired t-test 3.969, P < 0.01). In patients with at least one lower limb wound, a strong linear relation was found between PPG and LDF toe pressure techniques with a Pearson’s r correlation coefficient of 0.920 ( P < 0.001). Conclusions: PPG and LDF toe pressure techniques are equivalent in patients with at least one lower limb wound, irrespective of the presence of diabetes. Therefore, in the presence of an ABI with inconclusive results, such as in a patient with noncompressible vessels, both toe pressure techniques can be used for assessing the vascular supply of the lower limb with a wound.

scholarly journals Laser doppler flowmetry assessment of microcirculation in children of 6–7 years old

2021 ◽  
Vol 20 (3) ◽  
pp. 46-53
Author(s):  
V. I. Kozlov ◽  
V. N. Sakharov ◽  
O. A. Gurova ◽  
V. V. Sidorov
Keyword(s):  
Blood Flow ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Lower Limbs ◽  
Doppler Flowmetry ◽  
Flow Modulation ◽  
Left Hand ◽  
Flow Fluctuations ◽  
Ongoing Development

Introduction. The state of the blood flow within the capillaries and close blood vessels is highly important in practice for the revealing of pathogenetic mechanisms of both systemic and local circulatory disorders. Aim of the study was to define the parameters of microcirculation and the level of blood flow fluctuations (flux) in the distal segments of upper and lower limbs (in fingers of hands and toes of feet) in children of 6–7 years old; and to describe the possible differences in the mechanisms of blood flow modulation in boys and girls. Materials and methods. Skin microcirculation was assessed in middle fingers of hands and great toes of feet in children of 6-7 years old (14 girls and 7 boys in prone position) by means of laser doppler flowmetry. Results. The ranges for parameters of microcirculation (PM) for distal segments of upper and lower limbs in children of mentioned age group were defined, also it was shown that the PM are significantly lower in the lower limbs comparing to those of the upper limbs (both in groups of girls and boys). Asymmetry of PM in the feet was not found; the features of right hand-left hand asymmetry for PM in girls and boys are described. The analysis of modulation of blood flow fluctuations (fluxmotions) of different frequencies showed the profound role of vasomotor (myogenic) rhythm for regulation of microcirculation. Conclusion. Increased neurogenic influences on the modulation of fluxmotions in girls of 6-7 years old may be an evidence of the ongoing development of the mechanisms of blood flow regulation, particularly the association with the growth rate of girls is possible.

The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud’s phenomenon secondary to collagenosis

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Drinda ◽  
Neumann ◽  
Pöhlmann ◽  
Vogelsang ◽  
Stein ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Plasma Viscosity ◽  
Laser Doppler ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Long Term Effects ◽  
Doppler Flowmetry

Background: Prostanoids are used in the treatment of Raynaud’s phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual. Patients and methods: The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud’s phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables). Results: Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud’s phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6. Conclusion: The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud’s phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.

Microcirculation disorders in patients with vibration disease and comorbidity

2020 ◽  
pp. 672-672
Author(s):  
A. N. Kuks ◽  
N. V. Slivnitsyna
Keyword(s):  
Type 2 Diabetes ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Combined Effects ◽  
Doppler Flowmetry ◽  
Vibration Disease ◽  
History Of

The results of laser Doppler flowmetry in patients with vibration disease associated with the combined effects of local and general vibration with a history of type 2 diabetes are presented.

Peculiarities of microcirculation in periodont tissues in children of key age groups sufficient type 1 diabetes. Part II

2019 ◽  
Vol 24 (2) ◽  
pp. 108-119 ◽  
Author(s):  
B. N. Davydov ◽  
D. A. Domenyuk ◽  
S. V. Dmitrienko
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Diabetic Microangiopathy ◽  
Healthy Children ◽  
Doppler Flowmetry

Relevance. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders. Identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.Materials and methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low efciency and redistribution of blood flow in favor of the nutritive link.Conclusions. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early – compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late – decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.

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