Epidermal-dermal crosstalk during burn wound scar maturation

Burn injuries arc among the worst traumas which can happen to man. The larger a burn injury, the more severe the consequences and the highcr the chance of an adverse outcome or even death. In The Netherlands each year 40,000 people visit a general practitioner for treatment of a burn wound and 1600 people require in-hospital care primarily for burns. Approximately 80% of the burn accidents happen in or around the house, mainly in the kitchen. Scalds, usually due to hot water, are the most common cause of hurns. Water at 60°C will create a deep dermal or full-thickness burn in three seconds, and at 70°C the same burn will occur in one second [I]. The temperature of freshly brewed coffee from a percolator is generally about 80°C, which is hot enough to cause a full-thickness burn in less than one second. Children are particularly at high risk to burns. Hot beverages, particularly coffee and tea, are the predominant cause of scald burns in children [2]. One study showed that 81 % of the burn injuries in children under the age of 5 were due to scalds [3]. Cooking oil, when hot enough to use for cooking, may be in the range of l50-l80oC and can consequently cause very severe burns. Other causes of burns are fire, electricity, chemical substances and even sunshine. In The Netherlands around 200 people die of their burn incident each year, mostly at the place of the accident. The case fatality rate of scald injury is low; instead most deaths occur in residential fires, commonly caused by careless smoking, by arson or by defective or inappropriately used heating devices [2]. Burn injury can also be selfinflicted, an attempt to commit suicide, most often caused by throwing and igniting a tlammable liquid over the victim.

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