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- Title
Investigating histological aspects of scars in children.
- Authors
Westra, I.; Verhaegen, P. D. H. M.; Korkmaz, H. Ibrahim; Braam, K. I.; Kaspers, G. J. L.; Niessen, H. W. M.; Niessen, F. B.
- Abstract
Objective: Very little is known about histological aspects of paediatric scars and the possible role of the immune system during their formation. In this study, the histology thoracic scars caused by the placement of an implantable central venous access device in children who underwent treatment for cancer was assessed. Method: The amount and type of collagen, the collagen orientation, the type of elastic fibres, the vascularsation, and the count of neutrophils, macrophages, and lymphocytes were analysed. The severity of scarring was assessed using the Vancouver scar scale (VSS). To evaluate the role of the immune system on scar severity and histology, the scars of children suffering from acute lymphoblastic leukaemia (ALL) were compared with the scars of children suffering from other types of childhood cancer. Results: Our results showed an extremely random orientation of the collagen fibres of the paediatric scars with a mean collagen orientation index of 0.22 (standard deviation (SD) 0.10, zero indicating a perfectly random orientation and a perfectly parallel orientation). A lower collagen orientation index was seen in scars with a lower VSS score (VSS score <3: 0.19 versus VSS score >3 0.29, p=0.037). A higher total VSS score, resembling a worse scar, was assessed to the scars in the non-ALL group compared with the children with ALL (mean ALL: 0.91 (0-3) versus mean non-ALL: 2.50 (0-6), p=0.037). Conclusion: To our knowledge, this is the first study investigating a wide array of histological aspects in paediatric scars. Compared with adult scars, an extremely random collagen orientation was found (0.22 in children versus 0.41 and 0.46 adult normotrophic and hypertrophic scars, respectively). A lower collagen orientation index was found in scars with a lower VSS score. In addition, less severe scarring was measured in children suffering from ALL compared with children suffering from other types of childhood cancer. This suggests that the immune system could play a role in the development of aberrant scarring and should be a target for future research. Declaration of interest: The authors state that they do not have any potential (financial) conflicts of interest to declare.
- Subjects
NETHERLANDS; LYMPHOBLASTIC leukemia treatment; BLOOD vessels; CANCER chemotherapy; COLLAGEN; COMPARATIVE studies; CONFIDENCE intervals; IMMUNE system; IMMUNOHISTOCHEMISTRY; LYMPHOCYTES; MACROPHAGES; MEDICAL equipment; NEUTROPHILS; SCARS; TUMORS in children; CROSS-sectional method; DESCRIPTIVE statistics; ODDS ratio; CHILDREN
- Publication
Journal of Wound Care, 2017, Vol 26, Issue 5, p256
- ISSN
0969-0700
- Publication type
Article
- DOI
10.12968/jowc.2017.26.5.256