Hearing Josephine V W, Horch Raymund E, Schmid Rafael, Geppert Carol I, Stumpfe Maximilian C
Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Krankenhausstr. 8-10, 91054 Erlangen, Germany.
Life (Basel). 2024 Dec 30;15(1):30. doi: 10.3390/life15010030.
Shrinkage, a heat-induced process, reorganizes collagen fibers, thereby reducing wound surface area. This technique, commonly applied in surgeries like periareolar mastopexy and skin grafting, is well-established. Despite its widespread use, modern imaging has recently enabled detailed observation of shrinkage's effects on tissue temperature and oxygenation. The aim of this study is to investigate the effects of shrinkage on histological level, temperature, and tissue oxygenation. Skin flaps were collected, marked, and subjected to shrinkage in vitro, with wound dimensions recorded before and after shrinkage. Biopsy samples were analyzed histologically. In our clinical set up, Snapshot NIR and FLIR thermography were used to assess tissue oxygenation and temperature changes before and after shrinkage. Shrinkage significantly reduced wound area by almost 47% ± 8.5%, with a 16.5% ± 6.0% reduction in length and a 36.5% ± 7.7% reduction in width. Tissue temperature rose by an average of 38.3 °C post-shrinkage, reaching approximately 65 °C. A slight decrease in oxygen saturation was observed following shrinkage. Histological analyses reveal collagen fiber denaturation and structural reorganization. Thermal shrinkage is an effective method for reducing wound size and tension, demonstrating potential for facilitating larger full-thickness skin grafts. Although minor decreases in oxygenation were observed, shrinkage may enhance wound healing by reducing tension at wound edges. Further studies are needed to quantify its impact on functional and cosmetic outcomes.
收缩是一种热诱导过程，可重组胶原纤维，从而减小伤口表面积。这种技术在乳晕周围乳房上提术和皮肤移植等手术中常用，且已得到充分确立。尽管其应用广泛，但现代成像技术最近已能够详细观察收缩对组织温度和氧合的影响。本研究的目的是调查收缩在组织学水平、温度和组织氧合方面的影响。收集皮瓣，进行标记，并在体外进行收缩处理，记录收缩前后的伤口尺寸。对活检样本进行组织学分析。在我们的临床设置中，使用Snapshot NIR和FLIR热成像技术评估收缩前后的组织氧合和温度变化。收缩使伤口面积显著减少近47%±8.5%，长度减少16.5%±6.0%，宽度减少36.5%±7.7%。收缩后组织温度平均升高至38.3℃，达到约65℃。收缩后观察到氧饱和度略有下降。组织学分析显示胶原纤维变性和结构重组。热收缩是减小伤口大小和张力的有效方法，显示出促进更大面积全层皮肤移植的潜力。尽管观察到氧合略有下降，但收缩可能通过减少伤口边缘的张力来促进伤口愈合。需要进一步研究来量化其对功能和美容效果的影响。
