scholarly journals Morphophysiological characteristics of skin microcirculation types in patients with Dupuytren’s contracture

2019 ◽  
Vol 17 (4) ◽  
pp. 24-32
Author(s):  
T. I. Dolganova ◽  
N. A. Shchudlo ◽  
N. G. Shihaleva ◽  
V. V. Kostin

Aim– to investigate the patterns of cutaneous microcirculation and their relationship with structural vascular changes in palmar hypoderm in patients with Dupuytren’s disease.Material and methods. In 26 patients with Dupuytren’s contracture aged between 45 and 70 years, the microcirculation of palmar skin was assessed before the planned surgical treatment using ultrasound pulsed Doppler (Minimax-Doppler K, SP Minimax, St. Petersburg, Russia) with a high-frequency sensor of 20 MHz and laser Doppler flowmetry (BLF21, Transonic Systems Inc., USA). The local 3-minute arterial ischemic test was performed in all patients by putting the occlusion cuff on the forearm. Histological analysis of intra-operative tissue specimens was done using light microscopy (Carl Zeiss Primo Star microscope with 3.1 MP UCMOS video camera) MicroCapture Ver 6.6 program was used for data acquisition.Results. The normocirculatory type of hemodynamics (1) was found in 17 % of observations; hyperemic (2) – in 19 %, congestive-spastic (3) – in 42 %, and congestive-static (4) – in 21 %. Histologically type 1 was characterized with initial signs of constrictive arterial remodeling and capillary occlusion, 2 – with marked hyperemia of the microcirculatory bed and diapedesis of blood cells, inflammatory perivascular infiltrates, 3 – with significant narrowing and deformations of lumens in small arteries and hyalinosis of arterioles, 4 – with pronounced polymorphism of capillary loops, significant changes in arteries and veins.Discussion. Hyperemic type of microcirculation reflects high activity of autoimmune inflammation. Congestic-spastic type indicates a significant decrease in the reactivity of precapillary microvessels. Congestic-stasic type is accompanied by the most pronounced constrictive vascular remodeling and denervation of the vascular bed.Conclusion. Dupuytren’s contracture is characterized with predominance of pathological types of microcirculation in palmar skin, which must be taken into account in individualized protocols of additive therapy. 

1997 ◽  
Vol 22 (4) ◽  
pp. 521-522 ◽  
Author(s):  
R. A. DUTHIE ◽  
R. B. CHESNEY

Percutaneous fasciotomy has long been established as a treatment for Dupuytren’s contracture. There have been no studies to date of the long-term results of this procedure. We followed up a group of 82 patients 10 years after operation in 1981 and 1982. Thirty-four per cent had had no further surgery. The mean time to further surgery in the rest was 60.4 months. Splitting of the palmar skin which healed with regular dressings occurred in three cases. No other complications were noted. Percutaneous fasciotomy can produce lasting improvement in patients with Dupuytren’s contracture and still has an important role in their overall management.


1992 ◽  
Vol 17 (3) ◽  
pp. 349-355 ◽  
Author(s):  
A. V. BONNICI ◽  
F. BIRJANDI ◽  
J. D. SPENCER ◽  
S. P. FOX ◽  
A. C. BERRY

The cytogenetics of cell cultures derived from Dupuytren’s tissue, adjacent palmar fascia and palmar skin from patients undergoing fasciectomy have been examined and the results compared to cell cultures established from palmar fascia, flexor retinaculum and palmar skin of patients undergoing carpal tunnel decompression. Chromosomal abnormalities were detected in cell cultures from Dupuytren’s tissue in eight of the nine patients studied. Clones of cells trisomic for chromosome 8 were found in five of the nine patients. Trisomy 8 was also present in two of five flexor retinaculum cultures from carpal tunnel syndrome cases. These findings in both Dupuytren’s contracture and carpal tunnel syndrome suggest the presence of chromosomal instability in the palmar fascia. The significance of the chromosomal abnormalities is however unclear, but they indicate a possible common pathway in the onset of pathological fibrosis.


Author(s):  
C. W. Klscher ◽  
D. Speer

Dupuytren's Contracture is a nodular proliferation of the longitudinal fiber bundles of palmar fascia with its attendant contraction. The factors attributed to its etiology have included trauma, diabetes, alcoholism, arthritis, and auto-immune disease. The tissue has been observed by electron microscopy and found to contain myofibroblasts.Dupuytren's Contracture constitutes a scar, and as such, excessive collagen can be observed, along with an active form of fibroblast.Previous studies of the hypertrophic scar have led us to propose that integral in the initiation and sustenance of scar tissue is a profusion of microvascular regeneration, much of which becomes and remains occluded producing a hypoxia which stimulates fibroblast synthesis. Thus, when considering a study of Dupuytren's Contracture, we predicted finding occluded microvessels at or near the fascial scarring focus.Three cases of Dupuytren's Contracture yielded similar specimens, which were fixed in Karnovskys fluid for 2 to 20 days. Upon removal of the contracture bands care was taken to include the contiguous fatty and areolar tissue which contain the vascular supply and to identify the junctional area between old and new fascia.


2019 ◽  
Vol 24 (2) ◽  
pp. 108-119 ◽  
Author(s):  
B. N. Davydov ◽  
D. A. Domenyuk ◽  
S. V. Dmitrienko

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.


1986 ◽  
Vol 34 (4) ◽  
pp. 1455-1458
Author(s):  
Yoshifumi Nagatani ◽  
Kotaro Imamura ◽  
Eiji Hirano ◽  
Takayoshi Suga

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