Diagnosis of Skin Burn-Induced Colon Circulatory Disorders Using Optical Coherence Tomography Angiography and Laser Doppler Flowmetry (Experimental Study).

Abstract

The condition of gastrointestinal tract determines in many respects the regenerative capacity and the risk of complications in patients with extensive skin burns. However, the mechanism of developing vascular dysfunction in the colon in the burned individuals has so far been poorly studied. The aim of the investigation is to study intramural circulatory disorders of the colon using optical coherence tomography angiography (OCTA) and laser Doppler flowmetry (LDF) in different time periods after modeling a thermal burn.

Materials and methods: A deep thermal skin burn was induced on the area covering 10% of the body surface of Wistar rats (n=15). The blood flow of the colon wall was continuously monitored for 15 min before and 45 min after the burn using OCTA and LDF. The colon wall was again studied on days 7 and 14 using the same OCTA and LDF techniques. At each time point (45 min, day 7 and 14), 5 animals were withdrawn from the experiment, the colon wall was taken for histological study. The colon wall samples from three control rats without thermal skin burns were also histologically investigated.

Results: During 45 min after the induction of the thermal burn, the in vivo OCTA and LDF techniques registered changes in intramural blood flow in the form of dropping of some arterioles and capillaries out of the general blood flow with concurrent activation of vascular shunts as a compensatory mechanism. Histologically, a marked edema of the submucosa, erythrocyte aggregation, and stasis in the capillary network were observed in this period. According to the OCTA and LDF data, the microcirculatory disorders in the colon were partially resolved by day 7, and by day 14 the analyzed indicators returned to the initial level. The data of the histological evaluation have shown that on day 7 after the burn induction, submucosal edema was absent, however, the signs of microcirculatory disorder and inflammatory changes remained. On day 14, the pathological changes in the tissues were not observed.

Conclusion: The OCTA and LDF methods allowed us to establish experimentally that during the first 45 min thermal burn causes considerable disturbances of the blood flow in the colon wall, which normalizes only by day 14 if no therapy is administered. The obtained data on the mechanism of circulatory disorder development in the colon may become a basis for choosing therapy directed to prevention of intestine dysfunction in people with burns.