The mechanism elucidation of pressure ulcer by using visualized microcirculation model

压疮是由于软组织在垂直力、剪切力等外力作用下发生不可逆性损伤而发生的。本研究的目的是通过活体显微镜观察垂直力、剪切力、缺血再灌注三种因素对小鼠脑缺血再灌注损伤的影响。毛细血管在32 mm Hg垂直力作用下不发生挤压和闭塞。我们新设计了一种紧凑型毛细血管内窥镜，它由配备接触式物镜的CCD视频探头和照明器组成。在本研究中，我们评估了床边人体毛细管镜检查仪器的有效性，以观察不同真皮区域的毛细血管血流。此外，还研究了组织压迫对真皮毛细血管血流的影响，以确定其临床应用价值。我们的毛细血管镜检显示了皮肤表面几乎所有部分的营养毛细血管血流。我们的观察表明，需要与动脉压力类似的垂直应力水平才能阻止毛细血管流动。从这些演示中可以看出，目前基于CCD视频探头的毛细管镜将作为床边人体毛细管镜应用于临床。

Pressure ulcer occurs due to soft tissue irreversible injury by external forces such as perpendicular force, shear stress. The aim of this study demonstrates the effectof three factors which are perpendicular force, shear stress, ischemic reperfusion injury in mice by intravital microscopic techniques.The cremaster muscle wistar rat model can observe the microcirculation in which blood flow is stopped by perpendicular force. Capillary vessel could not crush and occlude by 32mmHgperpendicular force. We newly designed a compact capillaroscopy which was composed with a CCD video-probe equipped acontact-type objective lens and illuminator. In the present study, we evaluated usefulness of the instrument for a bed-side human capillaroscopy to observe the capillary flow in various dermal regions. The influences of tissue compression on the dermal capillary blood flow were also investigated to confirm the utility for clinical applications. Our capillaroscopy visualized the nutritional capillary blood flow in almost all parts of skin surface. Our observations showed that a level of vertical stress similar to arterial pressure was required to stop the capillary flow.From these demonstrations the present CCD video-probe based capillaroscopy would be useful for clinical applications as a bed-side human capillaroscopy.