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在具有营养性灌注与动静脉灌注的皮肤部位,对愈合伤口的微血管组成进行了比较。

The microvascular composition of the healing wound compared at skin sites with nutritive versus arteriovenous perfusion.

作者信息

Rendell M S, Milliken B K, Finnegan M F, Finney D E, Healy J C, Bonner R F

机构信息

Department of Medicine, The Creighton University School of Medicine, 601 North 30th Street, Omaha, Nebraska, 68131, USA.

出版信息

J Surg Res. 1998 Dec;80(2):373-9. doi: 10.1006/jsre.1998.5463.

Abstract

Background. In the rat, there is a significantly greater blood flow response to wounding at the back, a site perfused mainly by small capillaries, than at the paw, which has a much higher density of arterioles and venules. Materials and methods. We characterized the microvascular composition of wounds at the two skin sites in 11 Wistar Kyoto rats using a quantitative imaging program. Blood flow was compared using laser Doppler technology. Results. Prior to wounding, skin blood flow was much greater at the paw (7.1 +/- 0.5 ml 100 g tissue-1 min-1) than at the back (2.1 +/- 0.1 ml 100 g tissue-1 min-1, P < 0.01) at baseline. Seven days after wounding, blood flow both at the center (8.3 +/- 1.4 ml 100 g tissue-1 min-1) and at the perimeter of the back wound (4.1 +/- 0.5 ml 100 g tissue-1 min-1) had increased substantially. In contrast, skin blood flow at the perimeter of the paw wound had increased moderately (12. 7 +/- 2.0 ml 100 g tissue-1 min-1), but there was no change at the center of the wound (6.9 +/- 0.9 ml 100 g tissue-1 min-1). There were three times more microvessels per mm2 at the paw site (39.3 +/- 3.6) than at the back (13.1 +/- 1.5) prior to wounding. The wound granulation tissue was very vascular; the numerical density of vessels was identical at back (166 +/- 9) and at paw (154 +/- 6). Despite the marked increase in blood flow at the perimeter of the back wound, there was no difference in the microvascular density (15. 2 +/- 1.4) compared to baseline, nor was there a difference at the paw perimeter (39.4 +/- 3.6) compared to baseline. Conclusions. This study demonstrates that the microvascular constitutions of granulation tissues at the paw and back are identical. Thus, the rise in flow at the back wound and reduction in flow at the paw wound are entirely consistent with similar microvascular compositions of these two sites. Yet, there is increased flow at the back wound perimeter where there is no significant change in microvascular constitution compared to unwounded skin. Therefore, a microvascular structure no different from that prior to wounding functions very differently after wounding. Clearly vasoregulatory factors impact on the wound to modify flow through the microvascular network.

摘要

背景。在大鼠中,与爪部相比,背部伤口处的血流反应显著更强,背部主要由小毛细血管灌注,而爪部的小动脉和小静脉密度更高。材料与方法。我们使用定量成像程序对11只Wistar Kyoto大鼠两个皮肤部位伤口的微血管组成进行了表征。使用激光多普勒技术比较血流情况。结果。在基线时,受伤前爪部的皮肤血流(7.1±0.5 ml 100 g组织-1分钟-1)比背部(2.1±0.1 ml 100 g组织-1分钟-1,P<0.01)大得多。受伤7天后,背部伤口中心(8.3±1.4 ml 100 g组织-1分钟-1)和周边(4.1±0.5 ml 100 g组织-1分钟-1)的血流均大幅增加。相比之下,爪部伤口周边的皮肤血流适度增加(12.7±2.0 ml 100 g组织-1分钟-1),但伤口中心无变化(6.9±0.9 ml 100 g组织-1分钟-1)。受伤前爪部每平方毫米的微血管数量(39.3±3.6)是背部(13.1±1.5)的三倍。伤口肉芽组织血管丰富;背部(166±9)和爪部(154±6)的血管数量密度相同。尽管背部伤口周边的血流显著增加,但与基线相比微血管密度无差异(15.2±1.4),爪部周边与基线相比也无差异(39.4±3.6)。结论。本研究表明爪部和背部肉芽组织的微血管构成相同。因此,背部伤口处血流增加而爪部伤口处血流减少与这两个部位相似的微血管组成完全一致。然而,背部伤口周边血流增加,而与未受伤皮肤相比微血管构成无显著变化。因此,与受伤前无差异的微血管结构在受伤后功能却大不相同。显然,血管调节因子对伤口产生影响,通过微血管网络改变血流。

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