The relationship between protease/anti-protease profile, angiogenesis and re-epithelialisation in acute burn wounds.

Journal article

In the management of partial thickness burns, it is difficult to balance between conservative management and surgical intervention. Our hypothesis was that a triangular relationship exists between protease/anti-protease profile at the burn wound surface, angiogenesis and re-epithelialisation. By manipulation of the biochemical profile at the wound level, we determined to affect the nature and extent of angiogenesis and resulting re-epithelialisation. We performed a randomised longitudinal observational study on partial thickness burns in adult patients presenting to two regional burns units. Our results demonstrated that a high-protease wound environment is associated with lower levels of the angiogenic factor VEGF, a lower more uniform change in wound bloodflow and a uniform well healed wound with an architecturally normal epidermis. In addition, we found that a low protease wound environment is associated with higher levels of the angiogenic factor VEGF, a higher wound bloodflow throughout the wound healing period and a more chaotic, hypercellular, overkeratinised, and chaotic thickened epidermis.

Authors: Caulfield, R; Tyler, M; Austyn, J; Dziewulski, P; McGrouther, D

• Publication status: Published
• Journal: Burns : journal of the International Society for Burn Injuries
• Volume: 34
• Issue: 4
• Pages: 474-486
• Publication date: 2008-06-01
• DOI: 10.1016/j.burns.2007.07.012
• EISSN: 1879-1409
• ISSN: 0305-4179
• Language: English
• Keywords: Adolescent; Adult; Cell Count; Peptide Hydrolases; Aged; Negative-Pressure Wound Therapy; Young Adult; Neovascularization, Physiologic; Skin; Bandages, Hydrocolloid; Middle Aged; Epithelial Cells; Immunohistochemistry; Humans; Wound Healing; Burns; Laser-Doppler Flowmetry