Dynamic Optical Coherence Tomography Is a New Technique for Imaging Skin Around Lower Extremity Wounds.

Area of Science:

• Vascular biology
• Medical imaging
• Wound healing research

Background:

• Chronic wounds, like venous leg ulcers, exhibit slow healing and recurrence due to factors including hypertension, inflammation, and impaired perfusion.
• Understanding the microvascular changes in chronic wounds is crucial for developing effective treatments.

Purpose of the Study:

• To investigate the utility of optical coherence tomography (OCT) in visualizing peri-wound skin capillaries and gaining insights into chronic wound pathology.
• To assess whether dynamic OCT can reveal distinct vascular characteristics associated with chronic wound healing.

Main Methods:

• Employed dynamic optical coherence tomography (dynamic OCT), a noninvasive imaging technique, to examine superficial dermal capillaries (down to 20 µm).
• Assessed vessel morphology and density in 15 chronic wounds, focusing on wound edges, wound bed, adjacent lipodermatosclerosis, and unaffected skin.
• Utilized a handheld probe for rapid, depth-resolved imaging.

Main Results:

• Dynamic OCT revealed significantly different vessel morphology and density in chronic wound edges compared to healthy skin.
• Observed clusters of glomeruli-like vessels and an absence of linear branching vessels at wound edges, indicative of tissue growth.
• Detected greater blood perfusion in the peri-wound area of chronic ulcers.

Conclusions:

• Dynamic OCT provides novel information about microvascular changes in chronic wounds, unavailable through other imaging modalities.
• The observed vascular abnormalities, such as glomeruli-like vessels, are associated with tissue growth and may explain impaired healing.
• OCT shows significant promise as a noninvasive tool for evaluating and studying the pathology of chronic ulcers.