Wound monitoring of pH and oxygen in patients after radiation therapy
Wound monitoring of pH and oxygen in patients after radiation therapy
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DOI：
10.1186/s13014-019-1413-y
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发表时间：
2019-11-11
影响因子：
3.6
通讯作者：
Haubner, Frank
中科院分区：
文献类型：
--
作者：
Auerswald, Steffen;Schreml, Stephan;Haubner, Frank
目的放射性损伤后伤口愈合障碍是一个重要的临床问题。虽然有各种各样的治疗方法，但没有客观判断治疗成功的策略。本研究的目的是评估放射治疗后不愈合伤口的pH值和氧气的2D发光成像系统。方法使用VisiSens（Presens，里根斯堡，德国）二维成像系统A1和A2分别对氧和pH进行发光二维成像。将生物相容性平面发光传感器箔应用于非辐照和辐照皮肤以及5名患者的放射性伤口，并测定pH和氧饱和度。结果pH值测量显示未照射皮肤（6.46 +/- 0.18）和照射皮肤（6.96 +/- 0.26）之间存在显著差异。放射性伤口显示出最高的pH值（7.53 +/- 0.26）。氧测量显示未辐照皮肤的平均氧饱和度为6.19 +/- 0.83 mmHg。在辐照皮肤上发现氧饱和度的最高值（28.4 +/- 2.4 mmHg），而辐照伤口的氧饱和度较差（9.4 +/- 2.2 mmHg）（平均值+/- s.e.m.）。结论pH和pO 2的常规检测可以很容易地纳入临床常规。测量的结果显示了对于辐照伤口中的伤口愈合不利的pH和氧饱和度条件。有趣的是，辐照伤口表现出比辐照皮肤更明显的缺氧，这反映在与未辐照皮肤相比pH和pO 2的改变上，这有可能在未来作为预后标志物。除了客观化放射后伤口愈合障碍的治疗成功外，还可以使用该方法预测放射治疗期间皮肤毒性的程度。
Objectives Postradiogenic wound healing disorders are an important clinical problem. While a variety of treatment modalities are available, there is no strategy to objectively judge treatment success. The aim of this study was to evaluate a 2D luminescence imaging system for pH and oxygen in non-healing wounds after radiotherapy. Methods Luminescence 2D imaging was performed with the VisiSens (Presens, Regensburg, Germany) 2D imaging systems A1 and A2 for oxygen and pH, respectively. Biocompatible planar luminescent sensor foils were applied to non-irradiated and irradiated skin as well as to radiogenic wounds of five patients and the pH and the oxygen saturation was determined. Results pH measurements showed significant differences between non-irradiated skin (6.46 +/- 0.18) and irradiated skin (6.96 +/- 0.26). Radiogenic wounds exhibited the highest pH values (7.53 +/- 0.26). Oxygen measurements revealed a mean oxygen saturation of non-irradiated skin of 6.19 +/- 0.83 mmHg. The highest value of oxygen saturation (28.4 +/- 2.4 mmHg) was found on irradiated skin while irradiated wounds had a poor oxygen saturation (9.4 +/- 2.2 mmHg) (mean +/- s.e.m.). Conclusion We found that routine measurement of pH and pO2 in patients could be easily integrated into the clinical routine. The results of the measurements show unfavorable pH and oxygen saturation conditions for wound healing in irradiated wounds. Interestingly, irradiated wounds exhibit a more pronounced hypoxia than irradiated skin which is reflected by an altered pH and pO2 compared to unirradiated skin, which has the potential to serve as a prognostic marker in the future. In addition to the objectification of the treatment success of postradiogenic wound healing disorders, the extent of skin toxicity could already be predicted during radiotherapy with this method.