Skin microcirculation structural changes diabetic foot ulcer patients

Objective To investigate the structure changes of foot skin microcirculation features of diabetic foot ulcer through comparing the foot skin microcirculation structure between diabetic and non diabetic foot. Methods 29 diabetes with foot ulcer and 19 non-diabetes with orthopedics foot malformation or trauma surgery in-patients were recruited in Sun Yat-sen Memorial Hospital from June 2011 to April 2012. Foot skin was collected to make paraffin section. The von Willebrand factor (vWF) and vascular endothelial growth factor (VEGF) and its antibody in vascular endothelial cells were showed by immunohistochemistry and the photographs were analysis by Image Pro 6.0 to compare the data of foot skin papillary layer of dermis between two groups. The t test compares the differences between two groups. Association between variables is examined by multiple logistic regression analysis. Results Compared with non-diabetic patients, the papillary dermal area ((1.6±0.5)×105 vs (1.1±0.4)×105 μm2, t=3.5, P<0.05) of diabetic patients was increased, but the papillary dermal density (63±18 vs 90±30, t=4.05, P<0.05) was decreased significantly; In diabetes, the microvascular density(109±34 vs 161±40, t=4.81, P<0.05)was lower, but the out diameter of microvascular((23.9±2.8)vs(21.9±3.2) μm, t=2.28, P<0.05) in dermal papilla was bigger. The endothelial cells number(8.2±1.5 vs 10.3±2.1, t=4.06, P<0.05)and the vascular endothelial cells number per unit area(320±150 vs 563±212, t=4.65, P<0.05)were reduced, on the contrary, the vascular endothelial cells thickness((4.0±0.4)vs(3.2±0.3)μm, t=6.47, P<0.05)was increased. At the same time, the expression of VEGF(0.34±0.04 vs 0.41±0.05, t=4.87, P<0.05)was decreased significantly. Conclusion The incidence and development of diabetes foot is involved with the change of foot skin microcirculation structure in papillary layer of dermis. Key words: Diabetic foot; Skin; Papillary dermis; Microcirculation