Article Title

Systemic decreases in cutaneous innervation after burn injury


A letter to the Editor of the Journal of Investigative Dermatology

Innervation of the skin is important in order to maintain functional sensation and enable appropriate response to environmental stimuli. Injury to the skin may involve peripheral nerve damage. Previous studies have shown an initial loss of nerve fibers followed by an increase above normal fiber density, which is followed by apoptosis and ultimately reduced innervation and sensory function in scar tissue (Hermanson et al., 1987; Stella et al., Supp.(767) 1994; Altun et al., 2001; Ward et al., 2004; Nedelec et al., 2005). Although some studies have found an association between reduced nerve density and sensation (Stella et al., 1994; Ward et al., 2004), other studies have not (Griffin et al., 2001; Nedelec et al., 2005). The contradictory nature of these findings is at least in part due to small sample numbers, incomplete functional and anatomical assessment, and the variable timeframes between injury and analysis. Herein, to better understand the changes in cutaneous innervation and sensory function, we have analyzed neuroanatomy in a rat model of burn injury, and assessed neuroanatomy in patients with unilateral burn injuries at least 18 months post-injury, which is commonly defined as the end point for scar maturity (Nedelec et al., 2005). All animal experiments were approved by the institutional animal ethics committee and were performed in accordance with the NHMRC Australian code of practice for the care and use of animals for scientific purposes. The human study was carried out in accordance with the regulations outlined in the national statement on ethical conduct in research involving humans issued by the NHMRC and was approved by the Royal Perth Hospital ethics committee.




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