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Critical Care
Published in: Critical Care 3/2009

Open Access 01-06-2009 | Research

Epidermal wound healing in severe sepsis and septic shock in humans

Authors: Marjo Koskela, Fiia Gäddnäs, Tero I Ala-Kokko, Jouko J Laurila, Juha Saarnio, Aarne Oikarinen, Vesa Koivukangas

Published in: Critical Care | Issue 3/2009

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Abstract

Introduction

The effect of sepsis on epidermal wound healing has not been previously studied. It was hypothesised that epidermal wound healing is disturbed in severe sepsis.

Methods

Blister wounds were induced in 35 patients with severe sepsis and in 15 healthy controls. The healing of the wounds was followed up by measuring transepidermal water loss and blood flow in the wound, reflecting the restoration of the epidermal barrier function and inflammation, respectively. The first set of suction blisters (early wound) was made within 48 hours of the first sepsis-induced organ failure and the second set (late wound) four days after the first wound. In addition, measurements were made on the intact skin.

Results

The average age of the whole study population was 62 years (standard deviation [SD] 12). The mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission was 25 (SD 8). The two most common causes of infections were peritonitis and pneumonia. Sixty-six percent of the patients developed multiple organ failure. The decrease in water evaporation from the wound during the first four days was lower in septic patients than in the control subjects (56 g/m2 per hour versus 124 g/m2 per hour, P = 0.004). On the fourth day, septic patients had significantly higher blood flow in the wound compared with the control subjects (septic patients 110 units versus control subjects 47 units, P = 0.001). No difference in transepidermal water loss from the intact skin was found between septic patients and controls. Septic patients had higher blood flow in the intact skin on the fourth and on the eighth day of study compared with the controls.

Conclusions

The restoration of the epidermal barrier function is delayed and wound blood flow is increased in patients with severe sepsis.
Appendix
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Metadata
Title
Epidermal wound healing in severe sepsis and septic shock in humans
Authors
Marjo Koskela
Fiia Gäddnäs
Tero I Ala-Kokko
Jouko J Laurila
Juha Saarnio
Aarne Oikarinen
Vesa Koivukangas
Publication date
01-06-2009
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2009
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc7932

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