Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany.
J Trauma Acute Care Surg. 2012 Jul;73(1):73-9. doi: 10.1097/TA.0b013e31824afddd.
Closed soft tissue injury (CSTI) induces local inflammation and progressive microvascular dysfunction. The aim of the study was to evaluate and compare the microvascular changes systematically in a precompartmental tissue injury by oxygen-to-see (O2C), a combined laser Doppler flowmetry and spectrophotometry system, and intravital fluorescence microscopy (IVM).
Fourteen Wistar rats were subjected to a trauma and a control group (both n = 7). CSTI was performed on the left lower limb by means of a standardized impact device. Controls received a sham CSTI. Capillary blood flow (QRBC), oxygen saturation (sO2), and postcapillary filling pressure (rHb) were measured noninvasively by O2C assessed in 2-mm and 8-mm depth underneath the skin. Measurements were done before and after trauma and hourly up to 24 hours. IVM of the soleus muscle was performed after 24 hours.
Before CSTI, O2C parameters did not reveal a difference between both groups. Up to 2 hours after trauma, QRBC was significantly increased in 8-mm tissue depth. No significant changes of sO2 and rHb were noted compared with controls. In 2-mm depth, significantly reduced QRBC and rHb levels were observed compared with 8 mm but with no significant changes after CSTI. IVM showed a significant increase of postcapillary blood flow with decreased functional capillary density, increased macromolecular leakage, and increased nicotinamide adenine dinucleotide hydride.
After CSTI in rats, there was an immediate increase of compartmental capillary blood flow with a slight increase of muscle oxygen saturation and unchanged postcapillary venous filling pressures as sign of a redistribution of blood between soft and muscle tissue. The severity of pathologic changes in the compartment was not reflected by O2C but by IVM.
闭合性软组织损伤（CSTI）会引起局部炎症和进行性微血管功能障碍。本研究旨在通过氧测（O2C）系统，即激光多普勒血流仪和分光光度仪的组合，以及活体荧光显微镜（IVM），系统地评估和比较预隔间组织损伤中的微血管变化。
14 只 Wistar 大鼠接受创伤，对照组（n=7）接受假 CSTI。通过标准化的冲击装置对左下肢进行 CSTI。对照组接受假 CSTI。通过 O2C 无创测量毛细血管血流（QRBC）、氧饱和度（sO2）和后毛细血管充盈压（rHb），在皮肤下 2mm 和 8mm 处进行评估。在创伤前后和 24 小时内每小时进行测量。24 小时后进行比目鱼肌 IVM。
在 CSTI 之前，两组之间的 O2C 参数没有差异。创伤后 2 小时内，8mm 组织深度的 QRBC 显著增加。与对照组相比，sO2 和 rHb 没有明显变化。在 2mm 深度，与 8mm 相比，QRBC 和 rHb 水平显著降低，但 CSTI 后没有明显变化。IVM 显示，后毛细血管血流增加，功能性毛细血管密度降低，大分子渗漏增加，烟酰胺腺嘌呤二核苷酸氢增加。
在大鼠 CSTI 后，隔室毛细血管血流立即增加，肌肉氧饱和度略有增加，后毛细血管静脉充盈压不变，提示软组织结构和肌肉组织之间的血液重新分布。O2C 无法反映隔间内病理变化的严重程度，但 IVM 可以反映。
