Is UV radiation beneficial in postburn wound healing?
Currently strict ultraviolet (UV) light avoidance strategies and utilizing sunblock containing products are generally advocated during the reepithelialization process as well as after wound closure. These recommendations are guided by a common appreciation of UV radiation as a predominant cause of skin cancer development. It is possible however that the currently accepted practice of near continuous UV protection abrogates the normal cutaneous response to injury, with melanocyte redistribution and pigmentation creating hypopigmented scars. We hypothesize that judicious UV exposure might in fact be beneficial for wound healing and skin homeostasis. UV light should be investigated as a potential modulator of keratinocyte-melanocyte cross-talk in wound healing. In vitro studies will have to prove whether UV radiation induced melanocyte activation might have a stimulatory paracrine effect on keratinocyte proliferation which could beneficially affect wound healing. We further hypothesize that UV exposure to wounds might stimulate and restore normal melanocyte distribution and melanin content in reepithelialized wounds preventing hypopigmentation. Furthermore, exposure of reepithelialized wounds to UV light might exert a photo protective effect in the skin by the production of melanin. This in turn may protect the epidermis from UV-induced damage and carcinogenesis. It is therefore proposed that moderate UV exposure should be commenced early in the healing process of cutaneous wounds. At present, current practice and literature do not support the notion that UV-sun block is necessary in postburn scar management. Burn scars do not seem to exert an enhanced risk for melanomagenesis, the occurrence of which has only very rarely been reported in burn scars. Different mutations in susceptibility genes or in genes involved in the control of the cell cycle or maintenance of cellular integrity which are UV radiation independent are involved in the initiation and promotion steps of skin cancer.
Rennekampff
H-O
HO
Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany. rennekampff.oliver@mh-hannover.de
Busche
M N
MN
Knobloch
K
K
Tenenhaus
M
M
D002056:Burns / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D014466:Ultraviolet Rays; D014945:Wound Healing