Testing the Reliability of Optical Coherence Tomography to Measure Epidermal Thickness and Distinguish Volar and Nonvolar Skin.

Autor: Baumann ME; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA., Haddad NR; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA., Salazar A; Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA.; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, Maryland, USA., Childers WL; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Rehabilitation Medicine, Center for the Intrepid, Brooke Army Medical Center, San Antonio, Texas, USA.; Department of Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA., Farrokhi S; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Physical Therapy, Chapman University, Irvine, California, USA., Goldstein NB; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Hendershot BD; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Physical Medicine & Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA., Reider L; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Thompson RE; Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA., Valerio MS; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA., Dearth CL; Research and Surveillance Section, Extremity Trauma and Amputation Center of Excellence, Defense Health Agency, Falls Church, Virginia, USA.; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA., Garza LA; Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.; Department of Cell Biology, Johns Hopkins School of Medicine, Baltimore, USA.; Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, USA.
Jazyk: angličtina
Zdroj: JID innovations : skin science from molecules to population health [JID Innov] 2024 Mar 20; Vol. 4 (4), pp. 100276. Date of Electronic Publication: 2024 Mar 20 (Print Publication: 2024).
DOI: 10.1016/j.xjidi.2024.100276
Abstrakt: In persons with limb loss, prosthetic devices cause skin breakdown, largely because residual limb skin (nonvolar) is not intended to bear weight such as palmoplantar (volar) skin. Before evaluation of treatment efficacy to improve skin resiliency, efforts are needed to establish normative data and assess outcome metric reliability. The purpose of this study was to use optical coherence tomography to (i) characterize volar and nonvolar skin epidermal thickness and (ii) examine the reliability of optical coherence tomography. Four orientations of optical coherence tomography images were collected on 33 volunteers (6 with limb loss) at 2 time points, and the epidermis was traced to quantify thickness by 3 evaluators. Epidermal thickness was greater ( P < .01) for volar skin (palm) (265.1 ± 50.9 μm, n = 33) than for both nonvolar locations: posterior thigh (89.8 ± 18.1 μm, n = 27) or residual limb (93.4 ± 27.4 μm, n = 6). The inter-rater intraclass correlation coefficient was high for volar skin (0.887-0.956) but low for nonvolar skin (thigh: 0.292-0.391, residual limb: 0.211-0.580). Correlation improved when comparing only 2 evaluators who used the same display technique (palm: 0.827-0.940, thigh: 0.633-0.877, residual limb: 0.213-0.952). Despite poor inter-rater agreement for nonvolar skin, perhaps due to challenges in identifying the dermal-epidermal junction, this study helps to support the utility of optical coherence tomography to distinguish volar from nonvolar skin.
Databáze: MEDLINE