A Study of Burns for Wound Ageing reveals Changes in Unburnt Skin with Implications for Future Research

Abstract

Thirty-three punch biopsy sets of burn wound edge and adjacent unburnt skin from burn wounds aged six hours to 23 days were obtained from 18 patients. Immunohistochemical staining was performed for transforming growth factor beta receptor, epidermal growth factor receptor and MIB-1 (which stains the cell cycle associated antigen ki-67) in addition to integrins alpha V, 5 and 3 to assess for temporal patterns that might assist in the ageing of burn wounds. There was an early (12hr-4day) rise in integrin alpha V expression, an increasing expression of transforming growth factor beta receptor from 12 hours onwards, and increased expression of MIB-1 commencing at 2 days. In biopsy samples from the edge of the burn there was a trend for an early (6 hr-4 day) rise in epidermal growth factor receptor expression. There were no discernable changes in integrin alpha 5 or 3. The striking feature was that biopsy samples from the adjacent, unburnt skin showed similar temporal staining patterns. A further study would be required to determine if the effect was generalised or local, but the observation of changes in unburnt tissue implies that careful consideration must be given to selecting control tissue.

Effect of gamma-hydroxybutyrate on keratinocytes proliferation: A preliminary prospective controlled study in severe burn patients

“…This finding can be considered relevant when referring to data previously outlined in a study aiming to describe the basic immunohistology of burn wound and adjacent unburned skin: An initial peak of Ki67 labeling was reported in both areas just after burn injury, followed by a marked labeling decrease after 20 days post-injury (number of positive cells being ≤5). [12] In the present study with continuous GHB infusion, the evolution pattern was the opposite: The number of positive cells remained quite much high. This could be explained by the mitogen effect of IGF1 on keratinocytes.…”

Using the Inflammatory Cell Infiltrate to Estimate the Age of Human Burn Wounds: A review and immunohistochemical study

“…It was not possible to standardise for burn depth, burn treatment, subject age or total burn area. Furthermore, no 'control'uninjured -skin was available for study as it would have been necessary to obtain control tissue from a site removed from the injured area (Langlois et al, 2005). Nonetheless, this study has shown that a temporal pattern to the cellular response to burn injury exists in a non- standardised setting that would be representative of forensic practice.…”

“…The material utilised has also been described in previously published studies (Langlois et al, 2005).…”

Visual and spectrophotometric observations related to histology in a small sample of bruises from cadavers

“…It is presumed the iron in the tissue resulted from an earlier injury at the site that was chosen as the control, which appeared normal with no outward signs of bruising. It has been previously noted that careful consideration has to be given to selection of control sites when studying injuries of the skin [18]. It is unknown how long iron persists in the skin following injury.…”