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Dynamic optical coherence tomography is a new technique for imaging skin around lower extremity wounds

Dynamic optical coherence tomography is a new technique for imaging skin around lower extremity wounds
Dynamic optical coherence tomography is a new technique for imaging skin around lower extremity wounds

Chronic wounds such as venous leg ulcers invariably heal slowly and recur. In the case of venous leg ulcers, poor healing of chronic wounds is variously attributed to ambulatory hypertension, impaired perfusion and diffusion, presence of chronic inflammation at wound sites, lipodermatosclerosis, and senescence. The aim of this study was to investigate whether a new technique, optical coherence tomography (OCT), which permits imaging of blood capillaries in the peri-wound skin, can provide new insights into the pathology. OCT and its recent variant, dynamic OCT, permit rapid noninvasive depth-resolved imaging of the capillaries in the superficial dermis via a handheld probe, showing the morphology and density of vessels down to 20 µm in diameter. We used dynamic OCT to investigate 15 chronic wounds and assess characteristics of the vessels at the 4 poles around the wounds, the wound bed, adjacent dermatosclerosis, and unaffected skin. The results of the study show that both vessel morphology and density in the wound edges are dramatically different from that in healthy skin, showing clusters of glomuleri-like vessels (knot-like forms or clumps) and an absence of linear branching vessels, and also greater blood perfusion. Such vessel shapes are reported to be associated with tissue growth. The OCT imaging procedure was rapid and well tolerated by patients and provided new information not available from other devices. Thus, OCT appears to have great promise as a tool for the evaluation and study of chronic ulcers.

capillary imaging, chronic wounds, optical coherence tomography, venous leg ulcer
1534-7346
Holmes, Jon
14e034a9-3a0d-4ba6-a9a0-b38144e61df3
Schuh, Sandra
c571a220-21e8-41c8-b0a2-b97d2dd37993
Bowling, Frank Lee
9872ff94-e533-432d-b22d-e9a458de7f6f
Mani, Raj
a2455444-1b55-4ead-9836-f1e13c84172f
Welzel, Julia
71c02feb-b5cf-4307-b0bc-957ac1586366
Holmes, Jon
14e034a9-3a0d-4ba6-a9a0-b38144e61df3
Schuh, Sandra
c571a220-21e8-41c8-b0a2-b97d2dd37993
Bowling, Frank Lee
9872ff94-e533-432d-b22d-e9a458de7f6f
Mani, Raj
a2455444-1b55-4ead-9836-f1e13c84172f
Welzel, Julia
71c02feb-b5cf-4307-b0bc-957ac1586366

Holmes, Jon, Schuh, Sandra, Bowling, Frank Lee, Mani, Raj and Welzel, Julia (2019) Dynamic optical coherence tomography is a new technique for imaging skin around lower extremity wounds. The International Journal of Lower Extremity Wounds. (doi:10.1177/1534734618821015).

Record type: Article

Abstract

Chronic wounds such as venous leg ulcers invariably heal slowly and recur. In the case of venous leg ulcers, poor healing of chronic wounds is variously attributed to ambulatory hypertension, impaired perfusion and diffusion, presence of chronic inflammation at wound sites, lipodermatosclerosis, and senescence. The aim of this study was to investigate whether a new technique, optical coherence tomography (OCT), which permits imaging of blood capillaries in the peri-wound skin, can provide new insights into the pathology. OCT and its recent variant, dynamic OCT, permit rapid noninvasive depth-resolved imaging of the capillaries in the superficial dermis via a handheld probe, showing the morphology and density of vessels down to 20 µm in diameter. We used dynamic OCT to investigate 15 chronic wounds and assess characteristics of the vessels at the 4 poles around the wounds, the wound bed, adjacent dermatosclerosis, and unaffected skin. The results of the study show that both vessel morphology and density in the wound edges are dramatically different from that in healthy skin, showing clusters of glomuleri-like vessels (knot-like forms or clumps) and an absence of linear branching vessels, and also greater blood perfusion. Such vessel shapes are reported to be associated with tissue growth. The OCT imaging procedure was rapid and well tolerated by patients and provided new information not available from other devices. Thus, OCT appears to have great promise as a tool for the evaluation and study of chronic ulcers.

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More information

e-pub ahead of print date: 7 January 2019
Keywords: capillary imaging, chronic wounds, optical coherence tomography, venous leg ulcer

Identifiers

Local EPrints ID: 427620
URI: https://eprints.soton.ac.uk/id/eprint/427620
ISSN: 1534-7346
PURE UUID: 063e363f-b9bd-4d71-881a-17bfe9516d30

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Date deposited: 24 Jan 2019 17:30
Last modified: 24 Jan 2019 17:30

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Contributors

Author: Jon Holmes
Author: Sandra Schuh
Author: Frank Lee Bowling
Author: Raj Mani
Author: Julia Welzel

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