Vascular Leg Ulcers

Misciali, Cosimo; Dika, Emi; Baraldi, Carlotta; Fanti, Pier ­Alessandro; Mirelli, Michele; Stella, Andréa; Bertoncelli, Marco; Patrizi, Annalisa

doi:10.1097/dad.0000000000000141

Cited by 11 publications

(13 citation statements)

References 15 publications

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“…Our histopathological observations are consistent with previous studies of chronic wounds, reporting loss of the intact epidermis at the wound edge (26) and hyperplasia, hyperkeratosis and spongiosis in the intact epidermis near the wound edge (26)(27)(28).…”

Section: Histological Evaluation Of Human Chronic Woundssupporting

confidence: 92%

E‐cadherin and aquaporin‐3 are downregulated in wound edges of human chronic wounds

Ernstsen

Riishede

Iversen

et al. 2023

APMIS

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Chronic wounds are defined as wounds that fail to proceed through the normal phases of wound healing; a complex process involving different dynamic events including migration of keratinocytes in the epidermis. Chronic wounds are estimated to affect 1–2% of the human population worldwide and are a major socioeconomic burden. The prevalence of chronic wounds is expected to increase with the rising number of elderly and patients with diabetes and obesity, who are at high risk of developing chronic wounds. Since E‐cadherin and the water channel aquaporin‐3 are important for both skin function and cell migration, and aquaporin‐3 is furthermore involved in wound healing of the skin demonstrated by impaired wound healing in aquaporin‐3‐null mice, we hypothesized that E‐cadherin and aquaporin‐3 expression may be dysregulated in chronic wounds. Therefore, we investigated the expression of E‐cadherin and aquaporin‐3 in biopsies from the edges of chronic wounds from human patients. This was accomplished by immunohistochemical stainings of E‐cadherin and aquaporin‐3 on serial sections followed by qualitative evaluation of staining patterns, which revealed low expression of both E‐cadherin and aquaporin‐3 at the wound edge. Future studies are needed to reveal if this downregulation is associated with the pathophysiology of chronic wounds.

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Section: Histological Evaluation Of Human Chronic Woundssupporting

confidence: 92%

E‐cadherin and aquaporin‐3 are downregulated in wound edges of human chronic wounds

Ernstsen

Riishede

Iversen

et al. 2023

APMIS

View full text Add to dashboard Cite

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“…Gethin's review supports the concept that the wound edges harbor the healing potential of wounds; D-OCT imaging can image the structure and function of capillaries in the microcirculation around wounds as demonstrated. 8 Miscali et al, 22 from the histopathology of venous, mixed arterio-venous, and ischemic leg ulcers, found several differences in both epidermal and dermal layers of these wounds, significant ones being granulation tissue, edema, collagen bundle degeneration, and fibrin being present in greater proportions in venous and then mixed arterio-venous ulcers in that order. By comparison, in ischemic leg ulcers, intraluminal thrombus and sclerosis were more evident.…”

Section: What Is In a Wound Edge?mentioning

confidence: 99%

Blood Vessel Density Measured Using Dynamic Optical Coherence Tomography is a Tool for Wound Healers

Mani

Holmes

Παπάνας

2021

The International Journal of Lower Extremity Wounds

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Dynamic optical coherence tomography (D-OCT) is a relatively new technique that may be used to study the substructures in the retina, in the skin and its microcirculation. Furthermore, D-OCT is a validated method of imaging blood flow in skin microcirculation. The skin around venous and mixed arterio-venous ulcers was imaged and found to have tortuous vessels assumed to be angiogenic sprouts, and classified as dots, blobs, coils, clumps, lines, and curves. When these images were analyzed and measurements of vessel density were made, it was observed that the prevalence of coils and clumps in wound borders was significantly greater compared with those at wound centers. This reinforced the belief of inward growth of vessels from wound edge toward wound center which, in turn, reposed confidence in following the wound edge to study healing. D-OCT imaging permits the structure and the function of the microcirculation to be imaged, and vessel density measured. This offers a new vista of skin microcirculation and using it, to better understand angiogenesis in chronic wounds.

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“…They found few papers on similar topics in the literature. Histologically, ulceration is described as loss of the epidermis and part of the dermis which rarely extends to subcutaneous tissue (13) . Ultrasound examination made it possible to assess these layers and visualize the tissue loss described above in a non-invasive way.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of high-frequency ultrasound to assess the healing progress of shin ulcers

2020

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Introduction: As the average lifespan becomes longer, the number of cases of chronic shin ulcers is rising, which is slowly becoming a societal problem. Currently, there no methods for objective evaluation of ulcer healing process. Aim of the study: The aim of the study was to assess the use of high-frequency ultrasound to monitor the healing of shin ulcers subjected to laser biostimulation. Material and methods: The study included 8 patients (4 men and 4 women) aged from 46 to 81 years with 9 shin ulcers in whom the healing process did not progress within 8 weeks despite effective causal treatment. The ulcers were subjected to laser biostimulation. The induced changes were monitored using high-frequency ultrasound and photographic records. Ultrasound examination was used to assess the depth of ulceration and the thickness of granulation tissue, migrating epidermis, subepidermal low-echogenic band (SLEB) and epidermis in the immediate vicinity. The wound severity index and ulcer vascularity were also assessed. Results: As a result of laser therapy, in 7 out of 9 cases the ulcers healed completely and in the remaining 2 cases ulcer size was reduced. During the ulcer healing process induced by laser therapy, ultrasound examination revealed decreasing ulcer depth, wound severity index and SLEB thickness. Granulation tissue increased in thickness and there was an epidermal formation effect (newly formed epidermis was much thicker than the one surrounding the wound and became thicker as a result of laser therapy sessions). During the healing of ulcers induced by laser therapy no significant changes were observed in ulcer vascularity and thickness of the surrounding epidermis. Conclusions: High-frequency ultrasound is a useful technique for the imaging of leg ulcers. It allows one to monitor their healing process induced by laser biostimulation. Further research on the subject needs to be pursued.

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Vascular Leg Ulcers

Cited by 11 publications

References 15 publications

E‐cadherin and aquaporin‐3 are downregulated in wound edges of human chronic wounds

E‐cadherin and aquaporin‐3 are downregulated in wound edges of human chronic wounds

Blood Vessel Density Measured Using Dynamic Optical Coherence Tomography is a Tool for Wound Healers

Usefulness of high-frequency ultrasound to assess the healing progress of shin ulcers

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