Evaluation der kutanen Mikrozirkulation des Handrückens im Alter – Implikationen für die Wundheilung in der Handchirurgie?

Zusammenfassung

Hintergrund: Die kutane Mikrozirkulation spielt erfahrungsgemäß eine wesentliche Rolle in der Wundheilung, wobei Wundheilungsstörungen auch in der Handchirurgie eine häufige Komplikation darstellen. In der gegenwärtigen wissenschaftlichen Literatur fehlen jedoch Untersuchungen zu einer möglichen altersabhängigen Veränderung der kutanen Mikrozirkulation des Handrückens.

Hypothese: Die kutane Mikrozirkulation am Handrücken differiert signifikant zwischen Probanden unterschiedlicher Altersklassen.

Methoden: 53 gesunde Probanden wurden entsprechend ihres Alters auf 2 Gruppen (Gruppe A:<40 Jahre, n=31 vs. B:≥40 Jahre, n=22) verteilt. Bei allen Teilnehmern wurde die kutane Mikrozirkulation am Handrücken mittels kombiniertem Laser-Doppler und Fotospektrometrie untersucht.

Ergebnisse: Die kutane Sauerstoffsättigung war in Gruppe A signifikant um 11% höher als in Gruppe B (A: 64,7±9,9% vs. B: 58,3±12,6%; p=0,044). In Gruppe B war demgegenüber die kutane Blutflussgeschwindigkeit signifikant um 27% höher (A: 43±19,6% vs. B: 56,7±21,1%; p=0,019).

Schlussfolgerung: Die Hypothese dieser Studie wurde bestätigt. Diese Studie kann erstmals signifikante Unterschiede in der kutanen Mikrozirkulation des Handrückens zwischen verschiedenen Altersklassen darlegen. Weitere klinische Studien sind notwendig, um zu untersuchen, ob bei verzögertem Heilungsverlauf eine ähnliche Verteilung der kutanen Mikrozirkulation am Handrücken vorliegt.

Abstract

Background: Cutaneous microcirculation has shown to play a key role in wound healing. Although healing disorders are still one of the most common complications in hand surgery, there still exists a lack of scientific research on possible age-related changes in cutaneous microcirculation at the dorsum of hand.

Hypothesis: Cutaneous microcirculation at the dorsum of the hand differs significantly between different age groups.

Methods: 53 healthy subjects were divided into 2 groups by age (Group A:<40 years, n=31 vs. Group B≥40 years, n=22). All subjects underwent measurement of the microcirculation at the dorsum of the hand with combined laser-Doppler and photo spectrometry.

Results: Cutaneous oxygen saturation was significantly higher in Group A than in Group B (A: 64.7±9.9% vs. B: 58.3±12.6%; p=0,044). In contrast, blood flow velocity was significantly higher in Group B (A: 43±19.6 AU vs. B: 56.7±21.1 AU; p=0.019).

Conclusion: The hypothesis of this study was confirmed. This is the first study to show significant differences of cutaneous microcirculation at the dorsum of the hand within different age groups. Further clinical trials are needed in order to examine if delayed wound healing can be correlated to impaired cutaneous microcirculation at the dorsum of the hand.

Schlüsselwörter

Handchirurgie - Mikrozirkulation - Perfusion - Hautalterung

Key words

hand surgery - microcirculation - vascularisation - skin ageing

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