ZusammenfassungVeränderungen in der Mikrozirkulation der Haut sind ein häufig beobachtetes Begleitphänomen vieler Erkrankungen, weit über das Spektrum dermatologischer Krankheiten hinausreichend. Nicht alle dieser Veränderungen haben einen Krankheitswert, viele treten temporär auf, ohne schwerwiegende Folgen zu verursachen. Dies trifft für viele inflammatorische Erkrankungen wie die Psoriasis vulgaris oder das atopische Ekzem zu.Daneben gibt es aber auch Erkrankungen, bei denen funktionell und morphologisch erkennbare Mikroangiopathien zu schwerwiegenden Krankheitsfolgen führen. Eine der wichtigsten Erkrankungen in diesem Zusammenhang ist die systemische Sklerose, eine autoimmune Systemerkrankung mit multiplen Organmanifestationen. Hier sind die Untersuchungen der kutanen Mikrozirkulation sowohl in der Erstdiagnose als auch in der Prognose‐ und Verlaufsbeurteilung von weitreichender Bedeutung.Auch bei Erkrankungen der peripheren Hämodynamik wie der peripheren arteriellen Verschlusskrankheit (pAVK) und der chronisch venösen Insuffizienz (CVI) spielt das Verständnis von Mikrozirkulationsstörungen eine wichtige Rolle für die Therapie und die Erfolgskontrolle therapeutischer Interventionen.

Objective: to study the characteristics of mechanisms of the distant stimulating effect of full-thickness skin autograft (FTSG) on microvascular perfusion in local and systemic microcirculation disorders. Materials and methods. The experiment was carried out on 87 white male rats, divided into 5 groups: 1) control; 2) animals with local microcirculation disorders induced by sciatic nerve transection and neuroraphy; 3) animals with systemic microcirculation disorders caused by alloxan-induced diabetes; 4) animals that underwent FTSG after sciatic nerve transection and neurography; 5) animals that underwent FTSG in alloxan-induced diabetes. Laser Doppler flowmetry (LDF) was used to study microcirculation of the dorsal skin of the rear paw. Serum concentrations of vasoactive substances, including catecholamines (CA), histamine, and vasculoendothelial growth factor (VEGF) in the experimental animals were measured. A morphological study of the tissues of the autograft site was carried out on day 42 of the experiment. Results. On day 42 of the experiment, FTSG normalized perfusion in local and systemic microcirculation disorders. FTSG decreases CA level in nerve injury, and to a greater extent in alloxan-induced diabetes. Serum histamine increase under FTSG was more pronounced in rats with nerve injury. Serum VEGF in rats with nerve injury and FTSG increased, which was not observed in alloxan-induced diabetes. Histological assay of the autograft site revealed degenerative changes in the epidermis and dermis of the autotransplant in both experimental models of microcirculatory disorders. Eosinophilic infiltration of the autograft site was more pronounced in nerve injury than in alloxan-induced diabetes. Conclusion. FTSG has a distant stimulating effect on microcirculation, which manifests itself in the same degree in both local and systemic microcirculation disorders. The distant stimulating effect of FTSG on microcirculation is multicomponent in nature and includes a set of regulatory reactions, whose severity differs in local and systemic microcirculatory disorders.

Das maligne Melanom steht seit einigen Jahren als „Modelltumor“ im besonderen Fokus der onkologischen Forschung. Viel häufiger als der „schwarze Hautkrebs“ sind jedoch die „weißen Hautkrebse“, wie das Basalzellkarzinom und das Plattenepithelkarzinom. Sichere Diagnostik und stadiengerechte Therapie sind auch bei diesen Tumorformen bedeutsam.

BACKGROUND:Unprotected hydrodynamic debridement can produce aerosols, with the risk of cross-contamination and infection for patients and medical staff. OBJECTIVE:To evaluate the hygienic safety and the role of aerosol prevention of a pulsatile debridement. METHODS & MATERIALS:Bacterial emissions during debridement of chronic ulcer wounds of seven patients using the Debri-Jet hydrodynamic in different modifications were analyzed. RESULTS:Only a special aerosol prevention system (vacuum sensor, flexible cuff applicator) was able to effectively avoid the emission of infection relevant pathogens. The emitted pathogenic spectrum reflects the wound colonization of the individual patient wound; the most mobilized and emitted species were Staphylococcus aureus and Pseudomonas aeruginosa. CONCLUSION:Unprotected pulsatile debridement can produce highly relevant bacterial emissions. Equipped with an elaborate aerosol prevention technique, the Debri-Jet is a hygienically safe and effective debridement system and poses no more hygienic risks than conventional debridement. Because even conventional nonhydrodynamic debridement can produce cross-contamination, basic hygienic precautions, including the wearing of masks, gloves, and eye-shield, and performance of the procedure by trained staff must be used during debridement. This work was supported in part by financial support from Human Med Aktiengesellschaft, D-19061 Schwerin without any influence over the scientific results of the investigation. Human Med, Schwerin, loaned the Debri-Jet system.