The relationship between protease/anti-protease profile, angiogenesis and re-epithelialisation in acute burn wounds

Robert H. Caulfield, Michael P.H. Tyler, Jon M. Austyn, Peter Dziewulski, Duncan A. McGrouther

Research output: Contribution to journalArticle

15 Scopus citations


In the management of partial thickness burns, it is difficult to balance between conservative management and surgical intervention. Our hypothesis was that a triangular relationship exists between protease/anti-protease profile at the burn wound surface, angiogenesis and re-epithelialisation. By manipulation of the biochemical profile at the wound level, we determined to affect the nature and extent of angiogenesis and resulting re-epithelialisation. We performed a randomised longitudinal observational study on partial thickness burns in adult patients presenting to two regional burns units. Our results demonstrated that a high-protease wound environment is associated with lower levels of the angiogenic factor VEGF, a lower more uniform change in wound bloodflow and a uniform well healed wound with an architecturally normal epidermis. In addition, we found that a low protease wound environment is associated with higher levels of the angiogenic factor VEGF, a higher wound bloodflow throughout the wound healing period and a more chaotic, hypercellular, overkeratinised, and chaotic thickened epidermis.

Original languageEnglish (US)
Pages (from-to)474-486
Number of pages13
Issue number4
StatePublished - Jun 1 2008
Externally publishedYes



  • Angiogenesis
  • Partial thickness burns
  • Protease/anti-protease profile
  • Randomised longitudinal observational study
  • Re-epithelialisation

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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