AUTHOR=Saleh Karim , Strömdahl Ann-Charlotte , Riesbeck Kristian , Schmidtchen Artur
TITLE=Inflammation Biomarkers and Correlation to Wound Status After Full-Thickness Skin Grafting
JOURNAL=Frontiers in Medicine
VOLUME=6
YEAR=2019
URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2019.00159
DOI=10.3389/fmed.2019.00159
ISSN=2296-858X
ABSTRACT=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-κB 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-1ß, IL-8, IL-6, TNF-α was analyzed, and particularly IL-1ß 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-κB 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.