Clinic of Hand, Plastic, Reconstructive and Burn Surgery, BG Trauma Center Tuebingen, University Tuebingen, Germany.
University Clinic of Plastic and Hand Surgery, University Hospital, University of Bern, Inselspital, Switzerland.
Clin Hemorheol Microcirc. 2019;71(3):291-298. doi: 10.3233/CH-180373.
Improvement of skin microcirculation would be beneficial in transplanted tissues and thus, there is a demand for effective, reliable and harmless angiogenic treatments. The aim of this study was to assess the effect of capsaicin application (CA), the remote effect of capsaicin application (REC), the impact of remote ischemic conditioning (RIC), and the impact of combined remote ischemic conditioning with capsaicin application (Comb) on human skin microcirculation.
Perfusion changes were assessed using a laser Doppler device (easyLDI, Aimago Lausanne). 30 healthy volunteers were enrolled and divided into two groups: 1) CA and REC: perfusion was assessed on both forearms after application of capsaicin cream on one forearm with an exposure time of 40 minutes. 2) RIC and Comb: perfusion of one forearm was assessed after four cycles of 5 min blood occlusion and 5 min reperfusion using a tourniquet on the contralateral upper arm and application of capsaicin on the ipsilateral forearm. Baseline skin perfusion measurements of both forearms were carried out initially and were used as intra-individual reference.
The conditioning techniques RIC and CA showed a significant increase in human skin perfusion, CA being superior to RIC. However, the combination of CA and RIC showed no additional improvement potential as compared to CA alone. Furthermore, a remote effect of capsaicin application could not be demonstrated. These results encourage to analyze if the conditioning treatments are also beneficial for transplanted tissue survival.
改善皮肤微循环对移植组织有益，因此需要有效的、可靠的、无害的血管生成治疗方法。本研究旨在评估辣椒素应用（CA）、辣椒素应用的远程效应（REC）、远程缺血预处理（RIC）和联合应用辣椒素与远程缺血预处理（Comb）对人体皮肤微循环的影响。
使用激光多普勒设备（easyLDI，Aimago Lausanne）评估灌注变化。招募了 30 名健康志愿者，并将其分为两组：1）CA 和 REC：在一只前臂涂抹辣椒素乳膏 40 分钟后，评估两只前臂的灌注情况。2）RIC 和 Comb：用止血带在对侧上臂进行 4 个 5 分钟的闭塞和 5 分钟的再灌注循环，同时在同侧前臂涂抹辣椒素，评估一只前臂的灌注情况。最初进行了两只前臂的基线皮肤灌注测量，并用作个体内参考。
1）涂抹辣椒素后皮肤灌注明显增加（CA = +328.3%，p > 0.05）。辣椒素没有引起远程皮肤灌注变化（REC）。2）RIC 显著改善皮肤灌注（RIC = +20.0%，p < 0.05）。与单独使用 CA 相比，RIC 和 CA 的联合应用并未改善皮肤灌注（Comb）。
RIC 和 CA 这两种调节技术均能显著增加人体皮肤灌注，CA 优于 RIC。然而，与单独使用 CA 相比，CA 和 RIC 的联合应用没有显示出额外的改善潜力。此外，未能证明辣椒素应用的远程效应。这些结果鼓励分析这些调节治疗方法是否对移植组织的存活也有益。
