Correlation between the expression pattern of dermal fibronectin and the morphology of migrating epidermis *
One reason for a delay in the wound healing of chronic wounds is a failure in re-epithelialization. Fibronectin plays a role in correct re-epithelialization. Assuming that the level of fibronectin expression is related to a delay in epithelialization. We investigated the expression of fibronectin in pressure ulcers and burn wounds using the immunofluorescence technique. We examined seven cases of pressure ulcers and five cases of burns（positive control）treated in our department between 1998 and 2003. Dermal fibronectin was not detected in two of the seven cases, and in the remaining five cases, the levels of dermal fibronectin were lower than normal. Histologically, in the two former cases in which dermal fibronectin was not detected, the apical migrating epidermis was thickened, dull-shaped or slightly dull-shaped and showed a little elongation. In the remaining five cases with lower fibronectin levels, the migrating epidermis was dull or slightly dull-shaped and had a little elongated or elongated to a short extent. In the burn cases（positive control）, the level of dermal fibronectin was above normal in three of the five cases, and was normal in the remaining two cases. In the three cases with above normal levels, the apical migrating epidermis was wedge-shaped, slightly wedge-shaped or dull-wedge shaped and ranged from middle-length to long. In the remaining two cases, which had the same normal fibronectin level, the apical migrating epidermis was dull wedge-shaped and showed mid-length elongation. Our results suggested that the shape of the apical migrating epidermis was related to the dermal fibronectin level. If this is the case, a decrease in dermal fibronectin may be a contributing factor to a delay in the re-epithelialization of pressure ulcers. (Accepted on September 15，2005）
