Kabbani Mohammad, Rotter Robert, Busche Marc, Wuerfel Waldemar, Jokuszies Andreas, Knobloch Karsten, Vogt Peter M, Kraemer Robert
Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany; Department of Trauma and Reconstructive Surgery, University of Rostock, Rostock, Germany; Plastic and Aesthetic Surgery, Hospital Essen Mitte, Essen, Germany; Department of Otolaryngology, Hannover Medical School, Hannover, Germany; and Sport Practice, Hanover, Germany.
Plast Reconstr Surg Glob Open. 2013 Nov 7;1(7):e48. doi: 10.1097/GOX.0b013e3182a4b9cb. eCollection 2013 Oct.
Plastic and reconstructive surgeons are commonly faced with chronic ulcerations and consecutive wound infections of the feet as complications in patients with diabetes and/or peripheral arterial occlusive disease (PAOD). Microcirculatory changes seem to play an important role. However, the evaluation of functional changes in the soft tissue microcirculation at the plantar foot using combined Laser-Doppler and Photospectrometry System has not yet been performed in patients with DM or PAOD.
A prospective, controlled cohort study was designed consisting of a total of 107 subjects allocated to 1 of 3 groups-group A: healthy subjects (57% males, 63.3 y); group B: patients with diabetes mellitus (DM) (53% males, 59.4 y); and group C: patients with PAOD (81% males, 66.1 y). Microcirculatory data were assessed using a combined Laser-Doppler and Photospectrometry System.
Global cutaneous oxygen saturation microcirculation at the plantar foot of healthy individuals was 8.4% higher than in patients with DM and 8.1% higher than in patients with PAOD (both P = 0.033). Patients with diabetes did not show significant differences in global cutaneous blood flow when compared with either healthy subjects or patients suffering from PAOD.
Functional microcirculation at the plantar foot differs between healthy subjects and patients suffering from diabetes or PAOD of the same age. Patients with either diabetes or PAOD demonstrate deteriorated cutaneous oxygen saturation with equivalent blood perfusion at the plantar foot. More clinical studies have to be conducted to evaluate therapeutical methods that might ameliorate cutaneous oxygen saturation within diabetic foot disease and PAOD.
整形和重建外科医生经常面临糖尿病和/或外周动脉闭塞性疾病（PAOD）患者足部慢性溃疡及连续性伤口感染等并发症。微循环变化似乎起着重要作用。然而，尚未使用激光多普勒和光光谱联合系统对糖尿病或PAOD患者足底软组织微循环的功能变化进行评估。
设计一项前瞻性对照队列研究，共107名受试者被分为3组中的1组——A组：健康受试者（男性占57%，平均年龄63.3岁）；B组：糖尿病（DM）患者（男性占53%，平均年龄59.4岁）；C组：PAOD患者（男性占81%，平均年龄66.1岁）。使用激光多普勒和光光谱联合系统评估微循环数据。
健康个体足底的整体皮肤氧饱和度微循环比糖尿病患者高8.4%，比PAOD患者高8.1%（P均=0.033）。糖尿病患者与健康受试者或PAOD患者相比，整体皮肤血流无显著差异。
健康受试者与同龄糖尿病或PAOD患者的足底功能性微循环存在差异。糖尿病或PAOD患者足底皮肤氧饱和度降低，但血流灌注相当。必须开展更多临床研究以评估可能改善糖尿病足病和PAOD患者皮肤氧饱和度的治疗方法。
