Study of fibroblast count for age estimation of cutaneous wounds

Abstract

The determination of wound age as well as the distinction between antemortem and postmortem wounds, has been one of the most important medico legal interest. Since 1867 the issue has been raised and has lead to numerous researches to determine the age of the cutaneous wound based on histological markers. This study analyzes the use of fibroblast as a marker to estimate the abrasion wound age. Objectives: To determine the wound age by using fibroblast as a marker which is identified by Hemotoxylin & Eosin (H&E) staining and the aid of immunohistochemical study of basic Fibroblast Growth Factor (bFGF). Subjects and Methods: 20 adult skin samples which display abrasion wounds were taken from the body which had sustained the abrasion wounds, admitted to the ward for treatment for various durations, however succumbed to the illness and subsequently undergone medico-legal autopsy. The samples were stained with immunohistochemical of basic Fibroblast Growth Factor (bFGF) and the fibroblasts were identified by the morphology and reactivity to the stain. The identified fibroblasts were counted in 10 high power fields of each sample and scored using 3-tier system as follows: 10-50 fibroblasts, >50-100 fibroblasts and > 100 fibroblasts. Results: Wounds age <3 days displayed 10-50 fibroblasts per 10 high power fields, wounds age 3-7 days showed marked increase in the number of fibroblast (> 100 fibroblasts) and the number of fibroblasts in wound age > 7 days were decreasing to 50-100 fibroblasts. There was significant correlation between the number of fibroblast and the age of the wound (p<0.0001). Conclusions: This study has shown that the number of fibroblast displayed a schema in wound healing and wound age. Therefore fibroblast is a useful marker to estimate the cutaneous wound age.