Article

Noninvasive measurement of reepithelialization and microvascularity of suction‐blister wounds with benchmarking to histology

Wound Repair and Regeneration, Wiley, ISSN 1524-475X

Volume 25, 6, 2017

DOI:10.1111/wrr.12605, Dimensions: pub.1100242241, PMID: 29316016,

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  1. (1) Department of Dermatology and Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
  2. (2) Zealand University Hospital, grid.476266.7, Zealand Region
  3. (3) University of Copenhagen, grid.5254.6, KU
  4. (4) Colgate-Palmolive (United States), grid.418753.c
  5. (5) Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark

Description

We explored use of the suction-blister wound model in the assessment of not only epidermal regeneration but also pain, the microvascular response and bacteriology. The effects of topical zinc sulfate were studied to articulate the methodologies in this double-blind trial. One epidermal suction blister (10 mm) was induced on each buttock in 30 healthy volunteers (15 females:15 males) and deroofed on day 0. The wounds were randomized to daily treatment with 1.4% zinc sulfate shower gel (n = 20), placebo (n = 20) or control (n = 20). Digital photography coupled with planimetry, transepidermal water loss (TEWL) measurement and optical coherence tomography (OCT) was benchmarked to the gold standard of histology of 60 full-thickness wound biopsies on day 4. Pain increased after application of the shower gels. Microvessel density, determined from OCT images, increased from day 0 to day 2 in the three groups but increased more with the placebo than with the zinc shower gel (p = 0.003) or the control treatment (p = 0.002) and correlated (rS  = 0.313, p = 0.015) with the inflammatory response on day 4, as determined by histology. Coagulase-negative staphylococci were more common in wounds compared with skin (p = 0.002) and was reduced (p = 0.030) with zinc sulfate treatment. Planimetric analysis of digital wound images was not biased (p = 0.234) compared with histology, and TEWL measurements showed no correlation (rS  = 0.052, p = 0.691) with epithelialization. Neoepidermal formation, determined by histology, did not differ (p = 0.290) among the groups. Zinc sulfate reduced (p = 0.031) the release of lactate dehydrogenase from cultured gel-treated keratinocytes isolated from the blister roofs. Therefore, combination of the standardized suction-blister wound model with noninvasive planimetry and OCT is a useful tool for assessing wound therapies. Zinc sulfate transiently dampened inflammation and reduced bacterial growth.

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Field Citation Ratio (FCR): 2.78

Relative Citation ratio (RCR): 0.96