Held Manuel, Bender Dominik, Krauß Sabrina, Wenger Andrea, Daigeler Adrien, Rothenberger Jens
At the Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University in Tuebingen, Germany, Manuel Held, MD, is a resident; Dominik Bender, MD, is a resident; Sabrina Krauß, MD, is a resident; Andrea Wenger, MD, is a Senior Physician; Adrien Daigeler, MD, is Head Physician; and Jens Rothenberger, MD, is a Senior Physician. The authors have disclosed no financial relationships related to this article. Submitted March 4, 2018; accepted in revised form July 11, 2018.
Adv Skin Wound Care. 2019 Feb;32(2):88-92. doi: 10.1097/01.ASW.0000549610.99102.01.
To examine perfusion changes in the heel skin of individuals with and without diabetes mellitus to understand how skin is pathologically affected by diabetes mellitus.
This case-control study was conducted at an academic hospital in Tuebingen, Germany. A total of 30 subjects were enrolled in the study: 15 with known type 2 diabetes mellitus and 15 without. Each subject was asked to lie in a supine position on a hard lateral transfer mat for 10 minutes.
Heel perfusion was quantitatively assessed directly after relief of pressure and after 3 and 6 minutes after relief of pressure using laser Doppler flowmetry and tissue spectrophotometry.
Directly after relief of pressure, blood flow increased in the superficial skin layers (2 mm below the surface of the skin) in both groups. However, in deep skin layers (8 mm below the surface of the skin), blood flow increased in patients with diabetes mellitus and decreased in healthy patients. Oxygen saturation (SO2) was higher in healthy subjects directly after pressure relief.
The increase in blood flow in superficial skin layers indicates reactive hyperemia after exposure in both groups. The prolonged hyperemia in deep skin layers in patients with diabetes indicates increased tissue vulnerability. Despite the increase in blood flow in deep skin layers, the SO2 and thus supply of tissue in patients with diabetes were reduced.
研究糖尿病患者和非糖尿病患者足跟皮肤的灌注变化，以了解糖尿病对皮肤的病理影响。
本病例对照研究在德国图宾根的一家学术医院进行。共有30名受试者参与研究：15名已知2型糖尿病患者和15名非糖尿病患者。要求每名受试者仰卧在硬侧转移垫上10分钟。
使用激光多普勒血流仪和组织分光光度法，在压力解除后、压力解除后3分钟和6分钟直接定量评估足跟灌注。
压力解除后，两组患者表皮层（皮肤表面以下2毫米）的血流均增加。然而，在真皮层（皮肤表面以下8毫米），糖尿病患者的血流增加，而健康患者的血流减少。压力解除后，健康受试者的氧饱和度（SO2）更高。
两组患者表皮层血流增加表明暴露后出现反应性充血。糖尿病患者真皮层充血时间延长表明组织易损性增加。尽管真皮层血流增加，但糖尿病患者的SO2及组织供应减少。
