Abstract
Skin avulsion is commonly seen in individuals exposed to heavy shearing forces. Subcutaneous tissue detachment and bone fractures usually accompany skin avulsion. Thus, the estimation of the extent of damaged tissue is very important. Currently, the viability of skin and subcutaneous tissue is determined by clinical observations, and these observations always underestimate the true extent of the avulsed skin. Herein, we synthesized an innovative probe, CH1055-GRRRDEVDK (CH1055-GK), which can specifically bind to caspase-3 so as to image skin avulsion and define necrotic regions. Our uptake and binding affinity tests in apoptotic cells and evaluation of the probe ex vivo and in vivo showed that the probe has a strong ability to bind caspase-3 in skin avulsion models and that it vividly detected the necrotic area in avulsed skins. Furthermore, the increased fluorescence intensity of the probe in the avulsed skin showed a larger affected area than that determined by clinical observations in live mice. Consequently, our results indicated that observation of the caspase-3-targeted probe CH1055-GK via NIR-II imaging allowed the clear detection of skin avulsion in subjects, indicating its potential as an imaging tool for the early diagnosis of skin avulsion and the determination of necrotic margins.
Highlights
The incidence of skin avulsion has increased dramatically due to traffic accidents and machine accidents in modern industry (Tosti and Eberlin, 2018; Weinand, 2018)
These clinical symptoms are often not accurate enough to predict the degree of skin avulsion injuries (Gagnier et al, 2013; Latifi et al, 2014; Sen et al, 2017), and this may result in extensive excision of avulsed skins and soft tissue or secondary infection and necrosis
Skin avulsion leads to damage to soft tissues and blood vessels, which may be associated with different biological processes including ischemia and hypoxia (Ballestin et al, 2018)
Summary
The incidence of skin avulsion has increased dramatically due to traffic accidents and machine accidents in modern industry (Tosti and Eberlin, 2018; Weinand, 2018). Clinicians usually determine the viability of avulsed skins through examination of cutaneous bleeding, skin color, pressure reactions, and microcapillary refills. These clinical symptoms are often not accurate enough to predict the degree of skin avulsion injuries (Gagnier et al, 2013; Latifi et al, 2014; Sen et al, 2017), and this may result in extensive excision of avulsed skins and soft tissue or secondary infection and necrosis. Female BALB/c (nu/nu) mice were obtained from Charles River Laboratories (Beijing Vital River Laboratory Animal Technology Co., Ltd.) and kept under sterile conditions before establishing the skin avulsion model. The mice were housed in separate cages and prepared for NIR-II imaging experiments
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