Kinetics of Physiological Skin Flora in a Suction Blister Wound Model on Healthy Subjects after Treatment with Water-Filtered Infrared-A Radiation

The effect of water-filtered infrared-A radiation (wIRA) on normal skin flora was investigated by generating experimental wounds on the forearms of volunteers utilizing the suction blister technique. Over 7 days, recolonization was monitored parallel to wound healing. Four groups of treatment were compared: no therapy (A), dexpanthenol cream once daily (B), 20 min wIRA irradiation at 30 cm distance (C), and wIRA irradiation for 30 min once daily together with dexpanthenol cream once daily (D). All treatments strongly inhibited the recolonization of the wounds. Whereas dexpanthenol completely suppressed recolonization over the test period, recolonization after wIRA without (C) and in combination with dexpanthenol (D) was suppressed, but started on day 5 with considerably higher amounts after the combination treatment (D). Whereas the consequence without treatment (A) was an increasing amount of physiological skin flora including coagulase-negative staphylococci, all treatments (B–D) led to a reduction in physiological skin flora, including coagulase-negative staphylococci. In healthy volunteers, wIRA alone and in combination with dexpanthenol strongly inhibited bacterial recolonization with physiological skin flora after artificial wound setting using a suction-blister wound model. This could support the beneficial effects of wIRA in the promotion of wound healing

Comparison of Transepidermal Water Loss and Laser Scanning Microscopy Measurements to Assess Their Value in the Characterization of Cutaneous Barrier Defects

The exact qualitative and quantitative analysis of wound healing processes is a decisive prerequisite for optimizing wound care and for therapy control. Transepidermal water loss (TEWL) measurements are considered to be the standard procedure for assessing the progress of epidermal wound healing. The damage to the stratum corneum correlates with an increased loss of water through the skin barrier. This method is highly susceptible to failure by environmental factors, in particular by temperature and moisture. This study was aimed at comparing TEWL measurements and in vivo laser scanning microscopy (LSM) for the characterization of the epidermal wound healing process. LSM is a high-resolution in vivo method permitting to analyze the kinetics and dynamics of wound healing at a cellular level. While the TEWL values for the individual volunteers showed a wide scattering, LSM permitted the wound healing process to be clearly characterized at the cellular level. However, a comparison between the two methods was very difficult, because the results provided by LSM were images and not numerical. Therefore, a scoring system was set up which evaluates the stages of wound healing. Thus, the healing process could be numerically described. This method is independent of any environmental factors. Providing morphologically qualitative and numerically quantitative analyses of the wound healing process and being far less vulnerable to failure, LSM is advantageous over TEWL

Characterization of wound healing by in vivo laser scanning microscopy

Recent developments of new optical technologies in the past years lead to modern analytical systems suitable for new applications in the field of dermatology. In our study we describe the value of in vivo laser scanning microscopy (LSM) for the characterization of wound healing. In contrast to the gold standard - the measurements of the transepidermal water lost (TEWL) - this optical method has the advantage not to be disturbed by any interstitial fluid or topically applied substances. Standardized superficial wounds were produced by the suction blister technique and the healing process of the wounds was investigated using LSM. The LSM method has been proven to be a suitable technique for an objective evaluation of the wound healing process. Quantitative analysis of the healing process was facilitated by introducing scales characterizing the exact healing phase of the investigated wounds. This study revealed that the onset of tissue repair is not rectricted to the edges of the cutaneous wound but is found at the same time around the area of the hair follicles. Small islands of corneocytes were forming around the hair follicles leading to fully covered wound surface consisting of a first layer of corneocytes.Die erfolgreiche Entwicklung der optischen Technologien in den letzten Jahren führte zu Analysesystemen, die speziell im Bereich der Dermatologie neue Möglichkeiten der Anwendung erschließen. Im vorliegenden Beitrag wird über den Einsatz eines In-vivo-Laser-Scan-Mikroskops zur Charakterisierung von Wundheilungsprozessen berichtet. Im Gegensatz zum Goldstandard - den Messungen des transepidermalen Wasserverlusts (TEWL) - hat diese optische Methode den Vorteil, dass sie nicht durch Störfaktoren wie Wundflüssigkeit und topisch applizierte Substanzen beeinflusst wird. In der vorliegenden Studie wurden definierte oberflächliche Wunden mit Hilfe der Saugblasentechnik erzeugt und deren Abheilungsprozess mit Hilfe der In-vivo-Laser-Scan-Mikroskopie (LSM) untersucht. Es zeigte sich, dass die LSM-Technik eine objektive Bewertung des Wundheilungsprozesses ermöglicht. Durch die Einführung von charakteristischen Stadien der Wundheilung ist es sogar möglich, eine quantitative Bewertung des Wundheilungsprozesses vorzunehmen. Im Rahmen der Untersuchungen konnte u.a. nachgewiesen werden, dass der Wundheilungsprozess nicht nur von den Wundrändern her erfolgt. Auch um die Haarfollikel bilden sich Inseln von Korneozyten, die allmählich miteinander verschmelzen und zu einer ersten Bedeckung der Wundoberfläche mit einer geschlossenen Zellschicht von Korneozyten führen

Application of laser scanning microscopy for the characterization of wound healing

Optical non-invasive methods have become more and more important for the characterization of skin lesions and for therapy control. In vivo laser scanning microscopy is a promising method which can be used for the analysis of cellular structures in the skin up to a depth of 250 µm. Therefore, laser scanning microscopy (LSM) is well-suited for the characterization of wound healing processes. In contrast to measurements of the transepidermal waterloss (TEWL) the laser scanning microscopy allows the analysis of the healing process on a cellular level. The course of wound healing determined by laser scanning microscopy was correlated with numerical values, which correspond to those used for measurements of TEWL, allowing the numerical characterization of the wound healing process. Laser scanning microscopy showed that wound healing starts not only from the wound edges but also from "islands" inside the wound area. In contrast to TEWL measurements the LSM analysis is not influenced by disturbing factors such as temperature, humidity and topically applied substances. Therefore, the laser scanning microscopy is well-suited for the characterization of different types of wound healing therapies including the topical application of creams and lotions.Optische, nicht invasive Verfahren finden in der Dermatologie zur Charakterisierung von Hautzuständen und zur Therapiekontrolle eine zunehmende Anwendung. Besonders geeignet ist hierfür die In-vivo-Laser-Scan-Mikroskopie, welche es ermöglicht, zelluläre Strukturen bis zu einer Tiefe von 250 µm in der Haut nachzuweisen. Damit eignet sich die In-vivo-Laser-Scan-Mikroskopie sehr gut, Wundheilungsprozesse zu charakterisieren. Im Gegensatz zur klassischen Analyse von Wundheilungsprozessen mit Hilfe des transepidermalen Wasserverlustes (TEWL) ermöglicht die In-vivo-Laser-Scan-Mikroskopie die Darstellung des Heilungsprozesses auf zellulärer Ebene. Mit Bewertungskriterien, welche die Stadien des Wundheilungsprozesses beschreiben, lässt sich der Heilungsprozess numerisch beschreiben. Die Untersuchungen zeigen, dass die Wundheilung nicht nur von den Rändern her erfolgt, sondern auch innerhalb der Wunde "Inseln" entstehen, von welchen die Erneuerung des Stratum corneum erfolgt. Im Gegensatz zu den TEWL-Messungen werden laser-scan-mikroskopische Untersuchungen nicht durch äußere Faktoren wie Temperatur, Luftfeuchtigkeit und topisch applizierte Substanzen gestört. Die In-vivo-Laser-Scan-Mikroskopie ist sehr gut dazu geeignet, die Wirkung von verschiedenen Formen der Wundbehandlung einschließlich der Applikation von Wundsalben zu charakterisieren

In-vivo-Analyse der Wundheilung mit optischen Methoden

The analysis of wound healing is important for the therapy control and for the development of drugs stimulating the healing process. Wounds cause damage to the skin barrier. A damaged stratum corneum leads to an increased water loss through the skin barrier. The standard measuring procedure for characterization of wound healing is the measurement of transepidermal water loss (TEWL). The disadvantage of this method is that it can be easily disturbed by the perspiration of the volunteers and by topically applied substances, for instance wound healing creams. In the study presented, in vivo laser scanning microscopy and optical coherent tomography were compared concerning the application for their analysis of wound healing processes. The laser scanning microscopy allows the analysis of the healing process on a cellular level. The course of wound healing determined by laser scanning microscopy was correlated with numerical values, allowing the numerical characterization of the wound healing process.Die Analyse der Wundheilung ist wichtig zur Therapiekontrolle und für die Entwicklung von Arzneimitteln zur Wundheilungsförderung. Wunden verursachen eine Schädigung der Hautbarriere. Ein geschädigtes Stratum corneum verursacht einen erhöhten Wasserverlust durch die Hautbarriere. Daher ist das Standardverfahren zur Charakterisierung von Wundheilungsprozessen die Messung des transepidermalen Wasserverlusts (TEWL). Der Nachteil dieser Methode ist die Störanfälligkeit durch die Perspiration der Probanden sowie durch topisch applizierte Substanzen, z.B. Wundheilungscremes. In der vorliegenden Studie werden die In-vivo-Laser-Scan-Mikroskopie und die optische Koheränztomographie in ihrer Aussagekraft, Wundheilungsprozesse zu charakterisieren, verglichen. Die In-vivo-Laser-Scan-Mikroskopie ermöglicht die Darstellung des Heilungsprozesses auf zellulärer Ebene. Mit Bewertungskriterien, die die Stadien des Wundheilungsprozesses beschreiben, lässt sich der Heilungsprozess numerisch beschreiben

Comparison of transepidermal water loss and laser scanning microscopy measurements to assess their value in the characterization of cutaneous barrier defects

The exact qualitative and quantitative analysis of wound healing processes is a decisive prerequisite for optimizing wound care and for therapy control. Transepidermal water loss (TEWL) measurements are considered to be the standard procedure for assessing the progress of epidermal wound healing. The damage to the stratum corneum correlates with an increased loss of water through the skin barrier. This method is highly susceptible to failure by environmental factors, in particular by temperature and moisture. This study was aimed at comparing TEWL measurements and in vivo laser scanning microscopy (LSM) for the characterization of the epidermal wound healing process. LSM is a high-resolution in vivo method permitting to analyze the kinetics and dynamics of wound healing at a cellular level. While the TEWL values for the individual volunteers showed a wide scattering, LSM permitted the wound healing process to be clearly characterized at the cellular level. However, a comparison between the two methods was very difficult, because the results provided by LSM were images and not numerical. Therefore, a scoring system was set up which evaluates the stages of wound healing. Thus, the healing process could be numerically described. This method is independent of any environmental factors. Providing morphologically qualitative and numerically quantitative analyses of the wound healing process and being far less vulnerable to failure, LSM is advantageous over TEWL. Copyright © 2011 S. Karger AG, Basel