Quantitative Analysis of Heel Skin Microcirculation Using Laser Doppler Flowmetry and Tissue Spectrophotometry

Abstract

OBJECTIVE: To examine perfusion changes in the heel skin of individuals with and without diabetes mellitus to understand how skin is pathologically affected by diabetes mellitus. METHODS: This case-control study was conducted at an academic hospital in Tuebingen, Germany. A total of 30 subjects were enrolled in the study: 15 with known type 2 diabetes mellitus and 15 without. Each subject was asked to lie in a supine position on a hard lateral transfer mat for 10 minutes. MAIN OUTCOME MEASURES: Heel perfusion was quantitatively assessed directly after relief of pressure and after 3 and 6 minutes after relief of pressure using laser Doppler flowmetry and tissue spectrophotometry. MAIN RESULTS: Directly after relief of pressure, blood flow increased in the superficial skin layers (2 mm below the surface of the skin) in both groups. However, in deep skin layers (8 mm below the surface of the skin), blood flow increased in patients with diabetes mellitus and decreased in healthy patients. Oxygen saturation (SO2) was higher in healthy subjects directly after pressure relief. CONCLUSIONS: The increase in blood flow in superficial skin layers indicates reactive hyperemia after exposure in both groups. The prolonged hyperemia in deep skin layers in patients with diabetes indicates increased tissue vulnerability. Despite the increase in blood flow in deep skin layers, the SO2 and thus supply of tissue in patients with diabetes were reduced.

Features of Microcirculatory Dysfunction According to Wavlet Analysis Laser Doppler Flowmetry in Patients With Chronic Ischemic Heart Disease and Concomitant Diffuse Liver Diseases

“…IS was larger in the group of patients with IHD, indicating a decrease in nutri tional blood flow when compared with healthy, which is consistent with the results of other studies [16]. In patients with DLD, a moderate decrease in A max E and A max M is observed, with an increase in IS, indicating moderate endothelial dysfunction, an increase in the myotonic tone of precapillary sphincters, and a slight decrease in nutritional blood flow when compared with healthy volunteers.…”

“…The results of the analysis of indicators of intracardiac hemodynamics were presented in our previous scientific publications [16], so in this article we reflect the state of microcirculatory dysfunction according to wavelet analysis of LDF.…”

“…Laser Doppler flowmetry (LDF) -was conducted on the device Laser Doppler flowmetr LAKK-02 (SPE "Lasma", Moscow) by conventional method [4,15,16,18]. LDF based on optical sensing of tissues by monochromatic signal and analysis of frequency spectrum of signals reflected from erythrocytes having Doppler fre quency shift [12,15].…”

“…In severe course, a moderate decrease in all indicators (both active and passive mechanisms of regulation of microcirculation) was observed. In cirrhosis of the liver there is a slight increase in all parameters except A max N, in cirrhosis of the liver the system (L-arginine-NO) of the reticulo-endothelial system of the liver is depleted, which causes deterioration of microcirculation [10,16,19].…”

A systematic review of diagnostic techniques to determine tissue perfusion in patients with peripheral arterial disease

“…Spectrophotometry, or micro-lightguide spectrophotometry is a non-invasive technique for determining microcirculation in the skin by means of continuous white and laser light [53,54]. The white light that is scattered by the tissue chromophores and the wavelength-dependent absorption spectra are both recorded [55].…”