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  • Title: Optical coherence tomography: a noninvasive method to assess wound reepithelialization.
    Author: Singer AJ, Wang Z, McClain SA, Pan Y.
    Journal: Acad Emerg Med; 2007 May; 14(5):387-91. PubMed ID: 17363766.
    Abstract:
    BACKGROUND: Accurate assessment of wound healing may require invasive tissue biopsies, limiting its clinical usefulness in humans. Optical coherence tomography (OCT) is a novel, high-resolution method using light reflection to obtain noninvasive cross sectional imaging of biological tissues. OBJECTIVES: To evaluate the utility of OCT for assessing wound reepithelialization in a porcine model. METHODS: The authors conducted an animal study with two domestic pigs. Excisional cutaneous wounds were created over the ventral surface of the animals using an electric dermatome set at a depth of 600 microm. The wounds were excised two or three days later and precisely marked to guide initial OCT and subsequent tissue slicing and microscopy. Comparing hematoxylin and eosin-stained histologic sections and the corresponding OCT images from each tissue sample permitted identification of the correlative micromorphology. Scatter and Bland-Altman plots were used to present the data. The primary measure of agreement was the standard deviation of the pairwise differences in percent reepithelialization between OCT and histology together with a 95% confidence interval. RESULTS: In normal skin, the epidermis was characterized by a thin, bright layer indicating a high degree of light scattering on OCT. The dermis below was characterized by a thicker, darker area indicating less scattering of light. All fresh excisional wounds lacked an outer bright layer of epidermis immediately after injury. At days 2 and 3, the wounds were partially reepithelialized. A new bright layer with intense light scattering was present on OCT corresponding to the neoepidermis on hematoxylin and eosin-stained sections. The correlation between percent reepithelialization measured with OCT and histology was 0.66 (p < 0.001), and the standard deviation of the differences was 11.0% (95% confidence interval = 8.4% to 16.1%). CONCLUSIONS: OCT accurately detects the presence or absence of the epidermal layer of skin, allowing noninvasive tracking of wound reepithelialization.
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