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Polarized Light Spectroscopy for Measurement of the Microvascular Response to Local Heating at Multiple Skin Sites
Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences.
Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
Linköping University, Department of Clinical and Experimental Medicine, Burn Center. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL. Östergötlands Läns Landsting, Sinnescentrum, Department of Anaesthesiology and Surgery UHL.
Linköping University, Department of Clinical and Experimental Medicine, Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of Plastic Surgery, Hand surgery UHL.
2012 (English)In: Microcirculation, ISSN 1073-9688, E-ISSN 1549-8719, Vol. 19, no 8, p. 705-713Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate whether TiVi, a technique based on polarized light, could measure the change in RBC concentration during local heating in healthy volunteers. Methods: Using a custom-made transparent heater, forearm skin was heated to 42 degrees C for 40 minutes while the change in RBC concentration was measured with TiVi. The perfusion response during local heating was measured at the same time with Laser Doppler flowmetry. Results: Mean RBC concentration increased (91 +/- 34 vs. 51 +/- 34 A.U. at baseline, p less than 0.001). The spatial heterogeneity of the RBC concentration in the measured skin areas was 26 +/- 6.4% at baseline, and 23 +/- 4.6% after 40 minutes of heating. The mean RBC concentrations in two skin sites were highly correlated (0.98 at baseline and 0.96 after 40 minutes of heating). The change in RBC concentration was less than the change in perfusion, measured with LDF. Unlike with LDF, a neurally mediated peak was not observed with TiVi in most of the test subjects. Conclusions: TiVi is a valuable technique for measuring the microvascular response to local heating in the skin, and offers a high reproducibility for simultaneous measurements at different skin sites, provided carefully controlled experiments are ensured.

Place, publisher, year, edition, pages
Informa Healthcare / John Wiley and Sons , 2012. Vol. 19, no 8, p. 705-713
Keywords [en]
tissue viability imaging; polarization light spectroscopy; local heating; red blood cell concentration; reproducibility
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-87225DOI: 10.1111/j.1549-8719.2012.00203.xISI: 000311373400004OAI: oai:DiVA.org:liu-87225DiVA, id: diva2:587381
Available from: 2013-01-14 Created: 2013-01-14 Last updated: 2019-07-23
In thesis
1. Studies on Polarised Light Spectroscopy
Open this publication in new window or tab >>Studies on Polarised Light Spectroscopy
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis project focuses on measurements of dermal microcirculation during vascular provocations with polarised light spectroscopy. This is done with a non-invasive method commercially available as Tissue viability imaging (TiVi) which measures concentration and oxygenation of red blood cells in the papillary dermis. Three studies were done with human subjects and one with an animal model, to validate and compare the TiVi technique with laser Doppler flowmetry, which is an established method of measuring dermal microcirculation.

The TiVi consists of a digital camera with polarisation filters in front of the flash and lens, with software for analysis of the picture. When taking a picture with the TiVi, the polarised light that is reflected on the skin surface is absorbed by the second filter over the lens (which is perpendicular to the first filter) but a portion of light penetrates the surface of the skin and is scattered when it is reflected on tissue components. This makes the light depolarised, passes the second filter, and produces a picture for analysis. The red blood cell (RBC) has a distinct absorption pattern that differs between red and green colour compared to melanin and other components of tissue. This difference is used by the software that calculates differences in each picture element and produces a measure of output which is proportional to the concentration of red blood cells. The oxygenation of RBC can also be calculated, as there is a difference in absorption depending on oxygen state.

The first paper takes up possible sources of error such as ambient light, and the angle and distance of the camera. The main experiment was to investigate how the local heating reaction is detected with TiVi compared to LDF.

In the second paper arterial and venous stasis are examined in healthy subjects with TiVi.

The Third paper is an animal study where skin flaps were raised on pigs, and the vascular pedicle is isolated to enable control of inflow and outflow of blood.The measurements were made during partial venous, total venous, and total arterial occlusion. The TiVi recorded changes in the concentration of RBC, oxygenation and heterogeneity and the results were compared with those of laser Doppler flowmetry.

In the fourth paper oxygenation and deoxygenation of RBC: s was studied. Studies were made on the forearms of healthy subjects who were exposed to arterial and venous occlusion. Simultaneous measurements were made with TiVi and Enhanced perfusion and oxygen saturation or EPOS, which is a new device that combines laser Doppler flowmetry and diffuse reflectance spectroscopy in one probe.

With TiVi, one can measure RBC concentration and oxygenation in the area of an entire picture or in one or multiple user defined regions of interest (ROI). Methods such as laser Doppler flowmetry makes single point measurements, which is a potential source of error both because of the heterogeneity of the microcirculation, and that the circulation be insufficient in the margins of the investigated area. TiVi has been able to measure venous stasis more accurately than laser Doppler flowmetry, and venous stasis is the more common reason for flaps to fail.

The TiVi is an accurate way to measure the concentration of RBC and trends in oxygenation of the dermal microcirculation. It has interesting possible applications for microvascular and dermatological research, monitoring of flaps, and diagnosis of peripheral vascular disease. Future clinical studies are needed as well as development of the user interface.  

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2019. p. 48
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1689
National Category
Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:liu:diva-159084 (URN)10.3384/diss.diva-159084 (DOI)9789176850428 (ISBN)
Public defence
2019-09-02, Belladonnasalen, Campus US, Linköping, 13:00 (English)
Opponent
Supervisors
Available from: 2019-07-23 Created: 2019-07-23 Last updated: 2019-08-02Bibliographically approved

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Tesselaar, ErikSjöberg, FolkeFarnebo, Simon

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Burn CenterFaculty of Health SciencesDepartment of Plastic Surgery, Hand surgery UHLDepartment of Anaesthesiology and Surgery UHLSurgery
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Microcirculation
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