Felix M Bläsius1, Björn-Christian Link2, Frank J P Beeres3, Lukas D Iselin4, Benjamin Moritz Leu5, Boyko Gueorguiev6, Kajetan Klos7, Bergita Ganse8, Sven Nebelung9, Ali Modabber10, Daphne Eschbach11, Christian David Weber12, Klemens Horst13, Matthias Knobe14. 1. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany. Electronic address: fblaesius@ukaachen.de. 2. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland. Electronic address: bjoern-christian.link@luks.ch. 3. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland. Electronic address: frank.beeres@luks.ch. 4. Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland. Electronic address: lukas.iselin@luks.ch. 5. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany. Electronic address: benjamin.leu@rwth-aachen.de. 6. AO Research Institute Davos, Switzerland. Electronic address: boyko.gueorguiev@aofoundation.org. 7. Department of Foot and Ankle Surgery, Catholic Hospital Mainz, Germany. Electronic address: k-klos@kkmainz.de. 8. Research Centre for Musculoskeletal Science & Sports Medicine, Faculty of Science and Engineering, School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom. Electronic address: b.ganse@mmu.ac.uk. 9. Department of Radiology, University Hospital RWTH Aachen, Germany. Electronic address: snebelung@ukaachen.de. 10. Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Germany. Electronic address: amodabber@ukaachen.de. 11. Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Germany. Electronic address: eschbach@med.uni-marburg.de. 12. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany. Electronic address: chrweber@ukaachen.de. 13. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany. Electronic address: khorst@ukaachen.de. 14. Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Pauwelsstraße 30, D-52074 Aachen, Germany; Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Switzerland. Electronic address: mknobe@ukaachen.de.
Abstract
PURPOSE: Wound healing complications are a major concern after open reduction and internal fixation (ORIF) in patients with calcaneal fractures. Microcirculation is known to play a key role in bone and soft tissue healing. The present study aimed to characterize and contrast the dynamics of changes in microcirculation comparing two different surgical procedures: A) ORIF and B) a minimally invasive approach (MIA). METHODS: Blood flow (BF[AU]), oxygen saturation (sO2[%]) and relative amount of haemoglobin (rHb[AU]) were measured at two depths (2 mm and 8 mm) non-invasively by spectrophotometry (Micro-Lightguide O2C®, LEA Medizintechnik, Giessen, Germany) before surgery and every 24 h after surgery for a duration of six days. A linear mixed model (LMM) was used to analyse longitudinal data and repeated measurements. RESULTS: Nineteen patients (44 years, range 21.9-71.0 years) were enrolled in the study. Surgical treatment consisted of ORIF (n = =15) and MIA (n = =9). The postoperative BF and sO2 at the 2 mm and 8 mm depths were higher in the ORIF group (BF: p < 0.001, p = =0.003; sO2: p = =0.001, p = =0.011). The BF at the 2 mm and 8 mm depths increased after surgery (2 mm: p = =0.003, 8 mm: p = =0.001) in both groups. This increase did not correlate with the surgical technique. sO2 and rHb values at the 8 mm depth decreased after surgery (sO2: p = =0.008, rHb: p < 0.001) in both groups, whereas sO2 at the 2 mm depth increased after surgery (p = =0.003). Furthermore, the surgical technique correlated with the postsurgical course of sO2 values at the 2 mm depth (p = =0.042). CONCLUSIONS: The spectrophotometry results were in line with the generally accepted phases of soft tissue wound healing. Postsurgical changes in microcirculation are predominantly independent of surgical techniques and may be primarily determined by wound and fracture healing. Future studies should focus on the potential of spectrophotometry to monitor wound healing after surgery. Moreover, studies with longer observation periods are needed in order to examine the changes in microcirculation during all wound-healing phases.
PURPOSE: Wound healing complications are a major concern after open reduction and internal fixation (ORIF) in patients with calcaneal fractures. Microcirculation is known to play a key role in bone and soft tissue healing. The present study aimed to characterize and contrast the dynamics of changes in microcirculation comparing two different surgical procedures: A) ORIF and B) a minimally invasive approach (MIA). METHODS: Blood flow (BF[AU]), oxygen saturation (sO2[%]) and relative amount of haemoglobin (rHb[AU]) were measured at two depths (2 mm and 8 mm) non-invasively by spectrophotometry (Micro-Lightguide O2C®, LEA Medizintechnik, Giessen, Germany) before surgery and every 24 h after surgery for a duration of six days. A linear mixed model (LMM) was used to analyse longitudinal data and repeated measurements. RESULTS: Nineteen patients (44 years, range 21.9-71.0 years) were enrolled in the study. Surgical treatment consisted of ORIF (n = =15) and MIA (n = =9). The postoperative BF and sO2 at the 2 mm and 8 mm depths were higher in the ORIF group (BF: p < 0.001, p = =0.003; sO2: p = =0.001, p = =0.011). The BF at the 2 mm and 8 mm depths increased after surgery (2 mm: p = =0.003, 8 mm: p = =0.001) in both groups. This increase did not correlate with the surgical technique. sO2 and rHb values at the 8 mm depth decreased after surgery (sO2: p = =0.008, rHb: p < 0.001) in both groups, whereas sO2 at the 2 mm depth increased after surgery (p = =0.003). Furthermore, the surgical technique correlated with the postsurgical course of sO2 values at the 2 mm depth (p = =0.042). CONCLUSIONS: The spectrophotometry results were in line with the generally accepted phases of soft tissue wound healing. Postsurgical changes in microcirculation are predominantly independent of surgical techniques and may be primarily determined by wound and fracture healing. Future studies should focus on the potential of spectrophotometry to monitor wound healing after surgery. Moreover, studies with longer observation periods are needed in order to examine the changes in microcirculation during all wound-healing phases.
Authors: Florian Peters; Nicole Heussen; Jana Herbstmann; Stephan Christian Möhlhenrich; Anna Bock; Kristian Kniha; Frank Hölzle; Ali Modabber Journal: Sci Rep Date: 2021-05-07 Impact factor: 4.379
Authors: Felix Marius Bläsius; Laura Elisabeth Stockem; Matthias Knobe; Hagen Andruszkow; Frank Hildebrand; Philipp Lichte Journal: Eur J Trauma Emerg Surg Date: 2022-01-06 Impact factor: 2.374