TY - JOUR

T1 - Inflammation Biomarkers and Correlation to Wound Status After Full-Thickness Skin Grafting

AU - Saleh, Karim

AU - Stromdahl, Ann-Charlotte

AU - Riesbeck, Kristian

AU - Schmidtchen, Artur

PY - 2019

Y1 - 2019

N2 - Background: A surgical site infection (SSI) is believed to be the result of an exaggerated inflammatory response. Objective: Examine the relationship between clinical status and inflammation biomarkers in full-thickness skin grafting wounds. Methods: Twenty patients planned for facial full-thickness skin grafting were enrolled. A week after surgery, all graft wounds were clinically assessed using a 3-step scale for inflammation (low, moderate, high). All wounds were swabbed for routine microbiological analysis and assessment of numbers of aerobic bacteria. Tie-over dressings from all patients were collected and used for wound fluid extraction and subsequent analysis of MMPs, cytokines, and NF-kappa B inducing activity. Results: Wounds with a high degree of inflammation contained increased total MMP activity (P <= 0.05) in their corresponding fluids. Likewise, the level of the cytokines IL-1 beta, IL-8, IL-6, TNF-alpha was analyzed, and particularly IL-1 beta was discriminatory for highly inflamed wounds (P <= 0.01). Moreover, bacterial loads were increased in highly inflamed wounds compared to wounds with a low degree of inflammation (P <= 0.01). NF-kappa B activation in the monocytic cell line THP-1 was significantly higher when these cells were stimulated by wound fluids with a high degree of inflammation (P <= 0.01). Growth of S. aureus in wounds did not vary between wounds with different degrees of inflammation (chi-square 3.8, P = 0.144). Conclusion: Biomarkers analyzed from tie-over dressings correlated to clinical wound healing in full-thickness skin grafting. Keywords

AB - Background: A surgical site infection (SSI) is believed to be the result of an exaggerated inflammatory response. Objective: Examine the relationship between clinical status and inflammation biomarkers in full-thickness skin grafting wounds. Methods: Twenty patients planned for facial full-thickness skin grafting were enrolled. A week after surgery, all graft wounds were clinically assessed using a 3-step scale for inflammation (low, moderate, high). All wounds were swabbed for routine microbiological analysis and assessment of numbers of aerobic bacteria. Tie-over dressings from all patients were collected and used for wound fluid extraction and subsequent analysis of MMPs, cytokines, and NF-kappa B inducing activity. Results: Wounds with a high degree of inflammation contained increased total MMP activity (P <= 0.05) in their corresponding fluids. Likewise, the level of the cytokines IL-1 beta, IL-8, IL-6, TNF-alpha was analyzed, and particularly IL-1 beta was discriminatory for highly inflamed wounds (P <= 0.01). Moreover, bacterial loads were increased in highly inflamed wounds compared to wounds with a low degree of inflammation (P <= 0.01). NF-kappa B activation in the monocytic cell line THP-1 was significantly higher when these cells were stimulated by wound fluids with a high degree of inflammation (P <= 0.01). Growth of S. aureus in wounds did not vary between wounds with different degrees of inflammation (chi-square 3.8, P = 0.144). Conclusion: Biomarkers analyzed from tie-over dressings correlated to clinical wound healing in full-thickness skin grafting. Keywords

KW - dermatologic surgery

KW - wound healing

KW - surgical site infection

KW - full-thickness skin grafting

KW - inflammation biomarkers

U2 - 10.3389/fmed.2019.00159

DO - 10.3389/fmed.2019.00159

M3 - Journal article

C2 - 31355202

VL - 6

JO - Frontiers in Medicine

JF - Frontiers in Medicine

SN - 2296-858X

M1 - 159

ER -