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Hemodynamics of leg ulceration assessed by laser Doppler flowmetry
1Department of Dermatology, Royal Liverpool University Hospital, U.K.
Background:
Cutaneous blood flow and the venoarteriolar reflex can be assessed in the leg by laser Doppler flowmetry.
Objective:
Our purpose was to compare these measurements in ulcerated and nonulcerated skin in venous and arterial disease and to determine whether either changes with healing.
Methods:
Studies were performed in 20 patients with venous disease, 16 with arterial disease, and 12 control subjects and repeated sequentially in 15 patients with small venous ulcers until they healed.
Results:
Blood flow in nonulcerated skin was greatest in venous disease (but not when severe ulceration was excluded). The reflex was exaggerated in nonulcerated skin in venous disease but attenuated in the base of both venous and arterial ulcers. The reflex reappeared in the base of the venous ulcers as they healed.
Conclusion:
Measurement of the venoarteriolar reflex in nonulcerated skin distinguished between venous and arterial disease and its reappearance in the base of venous ulcers was associated with healing.