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COMPARATIVE STUDY
JOURNAL ARTICLE
Study of microvascular structure in keloid and hypertrophic scars: density of microvessels and the efficacy of three-dimensional vascular imaging.
Journal of Plastic Surgery and Hand Surgery 2010 December
We have investigated the blood vessels in keloids and hypertrophic scars, both morphologically and statistically. We also tried to construct three-dimensional images of blood vessels in a keloid and hypertrophic scar to clarify the vascular patterns. Keloids (n = 16) and hypertrophic scars (n = 12) were stained with haematoxylin and eosin, and immunostained with anti-CD31 antibody. The capillary density (number/1.0 mm(2)) and length of the major and minor axes were measured, and the major:minor axis ratio was calculated. Eighty serial sections were prepared from the preparations. Using image preparation software (Realia, INTAGE), the 80 input images were superimposed to construct a three-dimensional image of blood vessels in the tissue. We initially succeeded in constructing three-dimensional images of blood vessels in a keloid and hypertrophic scar. By statistical analysis of the vascular density and morphology, we clarified that there were fewer capillaries in keloids than in hypertrophic scars (p < 0.01), and that the vascular lumen was flattened. Capillaries in the central region of keloids tended to flat, compared with those in the marginal region. Three-dimensional images suggested that there was no microvascular communication in keloids; there was also an inadequate blood supply in keloid tissue. These findings may be a result of the growth of collagen and fibroblasts with keloid maturation.
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