Plastic and Reconstructive Surgery Research, Manchester Institute of Biotechnology (MIB), University of Manchester, 131 Princess Road, Manchester, M1 7ND, U.K; University Hospital of South Manchester NHS Foundation Trust, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, U.K; School of Materials, University of Manchester, Manchester, M13 9PL, U.K.
Br J Dermatol. 2014 Apr;170(4):840-50. doi: 10.1111/bjd.12786.
Gold-standard assessment of acute wound healing has traditionally been through histological analysis of biopsied tissue. However, this process is invasive with recognized side-effects. Optical coherence tomography (OCT) is a noninvasive technique generating high-resolution real-time images of cutaneous architecture.
To compare OCT with histological assessment of in vivo acute wound healing and ascertain the level of agreement between modalities for measurement of defined cutaneous structures.
Punch biopsies (5 mm) were harvested from 50 healthy volunteers. Wounds healed by secondary intention until they were re-excised 7, 14, 21 or 28 days later depending on random group allocation. Wounds were assessed weekly for 6 weeks using OCT and compared with histological findings derived from time-matched biopsies. Dimensions of four cutaneous structures were measured using both modalities and the level of agreement was established by Bland-Altman analysis. The mean greyscale value (MGV) of the upper reticular dermis was derived from OCT images at all time points.
Both techniques showed anatomical congruity in normal and wounded skin with correlating architectural changes associated with inflammatory, proliferative and remodelling wound healing phases. MGV was significantly increased 6 weeks after wounding (P = 0·001) and may represent a novel measure of wound fibrosis. Despite good association of histomorphometric values with low but consistent bias (range -4·181 to 0·431 μm), Bland-Altman plots demonstrated poor agreement between OCT and histology.
Optical coherence tomography enabled accurate assessment of healing tissue comparable with histological analysis of biopsy specimens. This noninvasive tool is highly suited to wound assessment and may represent a diagnostic alternative to punch biopsies.
传统上，对急性伤口愈合的金标准评估是通过对活检组织进行组织学分析。然而，这种过程具有侵入性，且公认具有副作用。光学相干断层扫描（OCT）是一种非侵入性技术，可生成皮肤结构的高分辨率实时图像。
比较 OCT 与组织学评估活体急性伤口愈合，并确定两种方法在测量特定皮肤结构方面的一致性程度。
从 50 名健康志愿者中采集 5mm 的打孔活检样本。根据随机分组，伤口通过二期愈合，直到 7、14、21 或 28 天后再次切除。在接下来的 6 周内，每周使用 OCT 对伤口进行评估，并将结果与来自时间匹配的活检的组织学发现进行比较。使用两种方法测量四个皮肤结构的尺寸，并通过 Bland-Altman 分析确定一致性程度。在所有时间点，从 OCT 图像中得出上网状真皮的平均灰度值（MGV）。
两种技术均显示正常和受伤皮肤的解剖学一致性，并且与炎症、增殖和重塑伤口愈合阶段相关的结构变化相关。MGV 在受伤后 6 周显著增加（P=0.001），可能代表一种新的伤口纤维化测量方法。尽管组织形态计量值具有良好的相关性，但存在低但一致的偏差（范围为-4.181 至 0.431μm），Bland-Altman 图表明 OCT 与组织学之间的一致性较差。
光学相干断层扫描能够准确评估愈合组织，与活检标本的组织学分析相当。这种非侵入性工具非常适合伤口评估，并且可能代表打孔活检的替代诊断方法。
