The acute impact of local cooling versus local heating on human skin microcirculation using laser Doppler flowmetry and tissue spectrophotometry
The acute impact of local cooling versus local heating on human skin microcirculation using laser Doppler flowmetry and tissue spectrophotometry
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DOI：
10.1016/j.burns.2019.03.009
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发表时间：
2020-02-01
期刊：
影响因子：
2.7
通讯作者：
Held, Manuel
中科院分区：
文献类型：
--
作者：
Bender, Dominik;Tweer, Stephanie;Held, Manuel
前言：人们对热致皮肤损伤的认识有所增加，但其病理生理机制尚不清楚。虽然人们认为局部降温可能会保护组织，但人们对局部加热对人体皮肤的影响知之甚少。材料与方法：使用TSA-II神经感觉分析仪对54名健康志愿者前臂掌侧局部低温(15℃和5℃)和局部高温(40℃和45℃)进行研究。结果：随着皮肤温度的降低，血流量和血流速度值呈持续下降趋势，而血氧饱和度(SO2)在浅层(2 Mm)和深层(8 Mm)呈持续升高趋势。随着皮肤温度的升高，表层和深层的流量、SO2和速度都有所增加。血红蛋白相对含量(RHb)无连续变化。讨论：局部降温可保护因SO2增加(氧耗量降低)而受损的组织。然而，局部降温导致血流和速度降低，限制了营养需求和代谢物的运输。尽管在更高的温度下组织的氧气消耗量更高，但血流量和二氧化硫都增加了。因此，我们假设，不仅低温，而且高温也可能提供组织保护。(C)2019年由爱思唯尔有限公司出版。
Introduction: Knowledge of thermally induced skin injury has increased, but its pathophysiology remains unclear. Although it is assumed that local cooling may protect tissue, little is known about the impact of local heating on human skin. This study aimed to evaluate acute skin perfusion dynamics following thermal stimuli in healthy human volunteers.Material and methods: In 54 subjects, a TSA-II-NeuroSensory Analyzer was used to induce local hypothermia (15 degrees C and 5 degrees C) and local hyperthermia (40 degrees C and 45 degrees C) at the palmar forearm of healthy volunteers. Changes in tissue microcirculation were assessed using an O2C device before and after each temperature change.Results: Blood flow and velocity values showed a continuous decrease with decreasing skin temperature, whereas haemoglobin oxygen saturation (SO2) showed a continuous increase in superficial (2 mm) and deep layers (8 mm). With increasing skin temperature, flow, SO2 and velocity increased in the superficial and deep layers. The relative amount of haemoglobin (rHB) did not show a continuous alteration.Discussion: Local cooling may protect damaged tissue due to increased SO2 (lower oxygen consumption). However, reduced blood flow and velocity in response to local cooling limit nutrient requirements and the transport of metabolites. Despite higher oxygen consumption of tissue at higher temperatures, both blood flow and SO2 increase. Thus, we hypothesize that not only hypothermia but also hyperthermia may provide tissue protection. (C) 2019 Published by Elsevier Ltd.