Microcirculation is similar in ischemic and venous ulcers

Microcirculation of 15 ischemic and 15 venous ulcers, their scars, and inta ct surrounding skin were examined in order to demonstrate their similaritie s in the development and healing process. Subpapillary and nutritive perfus ion of four areas were investigated by a laser Doppler perfusion imager (ar bitrary units) and capillary microscopy (capillaries/mm(2)): one ulcer area without granulation tissue (no wound healing) and one with granulation tis sue (ulcer healing); one skin area adjacent to the ulcer (1-8 mm) (scar dev eloped from ulcer areas) and one distant (12-25 mm; intact skin). Areas wit hout granulation tissue in ischemic and venous ulcers were similar, demonst rating a lack of capillaries (0.13 +/- 0.52; 0.93 +/- 2.09) and low laser D oppler flux (0.81 +/- 0.69; 1.47 +/- 1.17; P > 0.05 for each). In granulati on tissue of both ulcers there was a tendency to a higher capillary density (0.67 +/- 1.40; 5.60 +/- 2.32; P < 0.0001 for venous ulcers) and a higher laser Doppler flux (1.15 +/- 0.67; 4.04 +/- 1.62; P < 0.0001 for venous ulc ers) than in areas without granulation tissue. In scars of ischemic and ven ous ulcers capillary density (8.18 <plus/minus> 8.84; 13.60 +/- 5.45) and l aser Doppler flux (1.72 +/- 1.00; 1.94 +/- 1.45) were similar (P > 0.05). I n skin distant from ischemic ulcers very high capillary density (24.63 +/- 1.89) was associated with low laser Doppler flux (0.99 +/- 0.59); distant f rom venous ulcer capillary density was moderate (10.47 +/- 3.42) while lase r Doppler flux was high (3.77 +/- 1.62; P < 0.0001 between both groups). Th e development and healing process of ischemic and venous ulcers is similar. Nutritive and subpapillary perfusion are involved in ulcer healing. In int act skin surrounding ischemic and venous ulcers, microcirculation is differ ent due to the underlying pathophysiology. (C) 2001 Academic Press.