[Two experimental models for wound vitality evaluation in forensic pathology: A clinical prospective non-interventional study and an animal model].

AIM OF THE STUDY:In forensic pathology, wound age evaluation allows to determine if a wound was inflicted before or after death, and to date wounds of different ages. This dating is performed in conventional histopathology by observing inflammatory cells and hemorrhage at the wound site. However, these criteria seem to show low sensitivity and/or specificity. The aim of our study was to compare two models of wound vitality evaluation: a human surgical model, and a porcine experimental model; using these histological criteria. PATIENTS AND METHOD:In the two human (n=38) and porcine (n=11) models, three wounds were performed at regular time-lapse before devascularization/sacrifice, and a control wound after devascularization/sacrifice. The main evaluation criteria were the presence of interstitial hemorrhage and the number of interstitial polymorphonuclear neutrophils at 10 high power fields. RESULTS:In the two models, the number of polymorphonuclears neutrophils was significantly higher in vital wounds compared to the post-devascularization/sacrifice wounds (P<0.001), with a very low sensitivity (human model: 4.3%; porcine: 47%). Hemorrhagic infiltration was more frequent in vital wounds (human: P<0.001; porcine: P=0.01), with a low specificity (human: 48%; porcine: 54%). DISCUSSION AND CONCLUSION:This first study confirms, in the two models, the limitations of conventional histopathology in wound vitality evaluation. The next step will be testing several immunohistochemical markers in the two models.