Burn-Wound-Exudate-Depth-of-Burn-Predicts-Cellular-Recruitment - Abstract
Previous research has demonstrated a correlation between burn injury and systemic
cytokine response. Moreover, conflicting studies have identified burn wound fluid as being rich
in either pro- or anti-inflammatory cytokines that may serve to modulate the healing process.
We hypothesized that the cellular makeup of burn wound exudate correlates to the depth
of burn insult. To test this, we collected blister fluid from five patients with superficial partial
thickness or deep partial-thickness burns admitted to our burn ICU. The cellular composition of
the fluid was compared to that of whole blood from a healthy patient using flow cytometry. Any
additional blister fluid was assayed for various cytokine expressions. The cellular constituency
of superficial partial-thickness burn wound fluid appears to be predominated by lymphocytes
whereas deep partial-thickness burn fluid is mostly made up of monocytes and granulocytes.
Additionally, fluid from these deeper burns has a concentration of hepatocyte growth factor
that was at least two times that seen in the fluid collected from the more superficial burns. Our
data suggests a correlation between the cellular makeup of burn wound exudate and the depth
of burn injury that may eventually serve as a surrogate measure of burn depth. Furthermore,
these findings may offer insight into the possible mec hanisms that lead to spontaneous healing
more superficial wounds versus the less predictable nature and clinical course seen with the
deeper partial-thickness burns.