Abstract
ObjectivesPostradiogenic wound healing disorders are an important clinical problem. While a variety of treatment modalities are available, there is no strategy to objectively judge treatment success. The aim of this study was to evaluate a 2D luminescence imaging system for pH and oxygen in non-healing wounds after radiotherapy.MethodsLuminescence 2D imaging was performed with the VisiSens (Presens, Regensburg, Germany) 2D imaging systems A1 and A2 for oxygen and pH, respectively. Biocompatible planar luminescent sensor foils were applied to non-irradiated and irradiated skin as well as to radiogenic wounds of five patients and the pH and the oxygen saturation was determined.ResultspH measurements showed significant differences between non-irradiated skin (6.46 ± 0.18) and irradiated skin (6.96 ± 0.26). Radiogenic wounds exhibited the highest pH values (7.53 ± 0.26). Oxygen measurements revealed a mean oxygen saturation of non-irradiated skin of 6.19 ± 0.83 mmHg. The highest value of oxygen saturation (28.4 ± 2.4 mmHg) was found on irradiated skin while irradiated wounds had a poor oxygen saturation (9.4 ± 2.2 mmHg) (mean ± s.e.m.).ConclusionWe found that routine measurement of pH and pO2 in patients could be easily integrated into the clinical routine. The results of the measurements show unfavorable pH and oxygen saturation conditions for wound healing in irradiated wounds. Interestingly, irradiated wounds exhibit a more pronounced hypoxia than irradiated skin which is reflected by an altered pH and pO2 compared to unirradiated skin, which has the potential to serve as a prognostic marker in the future. In addition to the objectification of the treatment success of postradiogenic wound healing disorders, the extent of skin toxicity could already be predicted during radiotherapy with this method.
Highlights
Squamous cell carcinoma continues to be the most common of the head and neck malignant tumors
PH/o2 imaging Luminescence 2D imaging was performed with the VisiSens 2D imaging systems A1 and A2 (PreSens, Regensburg Germany) for oxygen and pH, respectively
Patients This study included 5 male patients between the ages of 51 and 77 who presented with wound healing disorders after adjuvant or primary radiochemotherapy (Fig. 3)
Summary
Squamous cell carcinoma continues to be the most common of the head and neck malignant tumors. It is known that radiotherapy leads to short and longterm changes in the irradiated tissue and is . The management of these complications requires extensive efforts [12] and is even further complicated by a lack of assessment criteria to objectively measure treatment success. Previous studies on chronic wounds have shown that adequate tissue oxygenation and pH regulation are essential for cell proliferation and protein synthesis [13, 14]. Cell turnover, migration and enzymatic activity are affected by changes in pH und subsequent activation of various proton-sensing G protein-coupled receptors (GPCRs) [15]
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