Dynamic Microcirculation Characteristics of Plantar Skin Under Metatarsal Head of Human Foot in Response to Life-Like Pressure Stimulus

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2024-06-05 DOI:10.1111/micc.12860

Zhenming Zhang, Wen-Ming Chen, Xiong-Gang Yang, Xingyu Zhang, Xu Wang, Jiazhang Huang, Chao Zhang, Xiang Geng, Xin Ma

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引用次数: 0

Abstract

Objective

Diabetic foot ulcer (DFU) is a severe complication with high mortality. High plantar pressure and poor microcirculation are considered main causes of DFU. The specific aims were to provide a novel technique for real-time measurement of plantar skin blood flow (SBF) under walking-like pressure stimulus and delineate the first plantar metatarsal head dynamic microcirculation characteristics because of life-like loading conditions in healthy individuals.

Methods

Twenty young healthy participants (14 male and 6 female) were recruited. The baseline (i.e., unloaded) SBF of soft tissue under the first metatarsal head were measured using laser Doppler flowmetry (LDF). A custom-made machine was utilized to replicate daily walking pressure exertion for 5 min. The exerted plantar force was adjusted from 10 N (127.3 kPa) to 40 N (509.3 kPa) at an increase of 5 N (63.7 kPa). Real-time SBF was acquired using the LDF. After each pressure exertion, postload SBF was measured for comparative purposes. Statistical analysis was performed using the R software.

Results

All levels of immediate-load and postload SBF increased significantly compared with baseline values. As the exerted load increased, the postload and immediate-load SBF tended to increase until the exerted load reached 35 N (445.6 kPa). However, in immediate-load data, the increasing trend tended to level off as the exerted pressure increased from 15 N (191.0 kPa) to 25 N (318.3 kPa). For postload and immediate-load SBF, they both peaked at 35 N (445.6 kPa). However, when the exerted force exceeds 35 N (445.6 kPa), both the immediate-load and postload SBF values started to decrease.

Conclusions

Our study offered a novel real-time plantar soft tissue microcirculation measurement technique under dynamic conditions. For the first metatarsal head of healthy people, 20 N (254.6 kPa)-plantar pressure has a fair microcirculation stimulus compared with higher pressure. There might be a pressure threshold at 35 N (445.6 kPa) for the first metatarsal head, and soft tissue microcirculation may decrease when local pressure exceeds it.

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跖骨头下足底皮肤对生活压力刺激的动态微循环特征

目的：糖尿病足溃疡（DFU）是一种严重的并发症，死亡率很高。足底压力过高和微循环不良被认为是导致糖尿病足溃疡的主要原因。具体目的是提供一种新技术，在类似行走的压力刺激下实时测量足底皮肤血流（SBF），并描述健康人在类似生活负荷条件下的第一跖骨头动态微循环特征：方法：招募 20 名年轻健康参与者（14 名男性和 6 名女性）。使用激光多普勒血流测量仪（LDF）测量第一跖骨头下软组织的基线（即无负荷）SBF。使用定制的机器模拟日常行走压力，持续 5 分钟。施加的足底压力从 10 牛顿（127.3 千帕）到 40 牛顿（509.3 千帕），每增加 5 牛顿（63.7 千帕）调整一次。使用 LDF 采集实时 SBF。每次施加压力后，都会测量负荷后 SBF 以进行比较。统计分析使用 R 软件进行：结果：与基线值相比，所有水平的即时负荷和负荷后 SBF 都显著增加。随着用力负荷的增加，后负荷和即时负荷 SBF 也呈上升趋势，直到用力负荷达到 35 牛顿（445.6 千帕）。然而，在即时负载数据中，当施加的压力从 15 牛顿（191.0 千帕）增加到 25 牛顿（318.3 千帕）时，增加趋势趋于平缓。对于后加载和即时加载 SBF，它们都在 35 牛顿（445.6 千帕）时达到峰值。然而，当施加的力超过 35 牛顿（445.6 千帕）时，即时加载和加载后 SBF 值都开始下降：我们的研究提供了一种新颖的动态条件下足底软组织微循环实时测量技术。对于健康人的第一跖骨头，20 牛顿（254.6 千帕）的跖压与更高的压力相比，对微循环的刺激效果较好。第一跖骨头的压力阈值可能为 35 牛顿（445.6 千帕），当局部压力超过该阈值时，软组织微循环可能会减少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.