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. 2025 Apr 4:44:493-505.
doi: 10.1016/j.jpra.2025.03.020. eCollection 2025 Jun.

Characterization of cutaneous microvasculature using 3D imaging: A feasibility study in a cohort of head and neck surgery patients with attention to smoking status

O M Alese  1   2 , A C Wilson  1   2 , K M Tessier  3 , A Loavenbruck  4   5 , C Dedeker  2 , A A Lassig  1   2
Affiliations

Characterization of cutaneous microvasculature using 3D imaging: A feasibility study in a cohort of head and neck surgery patients with attention to smoking status

O M Alese et al. JPRAS Open. .

Abstract

Background: This study explored a new method to characterize cutaneous microvasculature and evaluated the associations between baseline vessel characteristics and post-operative wound healing outcomes.

Materials and methods: We prospectively enrolled 17 adult patients undergoing major head and neck surgery. A full thickness cutaneous biopsy from the inferior surgical skin flap of the neck incision was obtained and processed for immunohistochemical analyses. Collagen IV antibody was immunolocalized along with secondary fluorophore-conjugated antibodies for confocal microscopy. The Vesselucida 360 software was used to morphologically characterize the cutaneous vasculature by tracing 3D sections of the collagen IV-stained vessels. Vessel structure metrics including isolated elements (individual vessel structures) and patient characteristics were evaluated for associations. Statistical analyses were performed using R version 3.6.1 and SAS version 9.4; a p-value of 0.05 was considered significant.

Results: Males and prior chemotherapy patients trended toward higher isolated elements compared with females and patients without a history of chemotherapy. Vesselucida assessment results indicated that current and former smokers were found to have more tortuous vessels and irregular vessel walls than never-smokers. Isolated elements were significantly higher in patients who returned to the hospital owing to a wound complication, required long-term wound care, or had other complications. Vascular endothelial growth factor A was positively correlated with vessel endings and total surface area, whereas placental growth factor was positively correlated with isolated elements and endings.

Conclusions: We described the use of Vesselucida 360 as an innovative tool to characterize cutaneous vasculature; using this tool, the increase in isolated elements was found to be associated with poorer wound healing outcomes.

Keywords: Cutaneous vasculature; Surgery; Vessel structure; Vesselucida 360; Wound healing.

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Figures

Figure 1:
Figure 1
Morphological Vessel Metrics.
Figure 2:
Figure 2
Morphological Vessel Metrics by Patient Characteristics.
Figure 3:
Figure 3
Total Vessel Size Metrics by Patient Characteristics.
Figure 4:
Figure 4
Confocal microscopy images of smokers (A), former smokers (B), and never-smokers (C).
Figure 5:
Figure 5
Vessel Metrics by Post-Operative Outcomes.
Figure 6:
Figure 6
Vessel Metrics by Wound Vascular Fluid.
See this image and copyright information in PMC

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