P. Betz, IMMUNOHISTOCHEMICAL PARAMETERS FOR THE AGE ESTIMATION OF HUMAN SKIN WOUNDS, The American journal of forensic medicine and pathology, 16(3), 1995, pp. 203-209
The immunohistochemical detection of stringlike ramifying structures p
ositive for fibronectin in wounds aged at least a few minutes provides
valuable information on the vitality of skin lesions even before the
appearance of neutrophilic granulocytes. Positive reactions for tenasc
in or collagen type III indicate postinfliction intervals of at least
2-3 days, whereas vital reactions for collagen type V or VI occur earl
iest 3 days after wounding. Collagen type I appears as spotlike fibrob
last-associated reaction products in injuries aged 4 days or more, whi
le typical stringlike ramifying fibers indicate a postinfliction inter
val of at least 5-6 days. Fibroblasts positively staining for laminin
or heparan sulfate proteoglycan can be detected in wounds with a survi
val time of similar to 1.5 days or more and collagen type-IV-positive
cells occur earliest 4 days after wounding, followed by alpha-smooth m
uscle actin expressing fibroblasts after 5 days or more. Basement memb
rane fragments positive for laminin, heparan sulfate proteoglycan, or
collagen type IV or VII indicate a wound age of at least 4 days, and a
complete restitution of the epidermal basement membrane in (surgical)
wounds can be observed earliest 8 days after wound infliction. Positi
vely reacting basement membrane fragments are absent up to a wound age
of <13 days, and the evidence of an incompletely rebuilt basement mem
brane indicates a postinfliction interval of less than similar to 22 d
ays. A continuous staining of the basal cells of the newly formed epid
ermis for cytokeratin 5 occurs earliest 13 days after wounding, and th
e absence of a complete staining provides information on a wound age o
f <24 days.