Regeneration of Subcutaneous Connective Tissue in Children

Abstract

Enzyme histochemical patterns of healing subcutaneous connective tissue were studied histo‐chemically in 20 pediatric patients using the CELLSTIC device. This wound drain consists of a standard size viscose cellulose sponge inside a thin silicone rubber tube. The CELLSTICs were drawn out of the wound 3–96 h after implantation. The sponges were studied for the activity of the following enzymes: acid and alkaline phosphatases, adenosine triphosphatase, aminopeptidase, hexokinase, and isocitrate dehydrogenase. During the first 12 h the enzyme histochemical pattern in the sponge resembled that of peripheral blood, whereafter the number of polymorphonuclear leukocytes increased. These cells exhibited an increasing enzyme activity when accumulating and invading, but their activity decreased concomitantly with their degeneration between 36–48 h. The polymorphonuclears were followed by monocytes and macrophages, showing increasing enzyme activities. Fibroblasts usually appeared at the end of the third postoperative day. Both their number and enzyme activity increased later on, especially when the fibroblasts appeared as clusters. Maximum activity of isocitrate dehydrogenase and hexokinase was reached relatively early in the youngest children. Wound healing is thus an age‐dependent process reflected by the increased time needed for the maximal activation of certain enzymes and for cellular transformation.