Chemokine profiles differ between intracutaneous and subcutaneous locations in early acute wound healing after breast reduction

This study describes chemokines and chemokine gradients which are regulated during the very early hours of normal wound healing by comparing chemokine concentrations in intracutaneous (superficial) and subcutaneous (deep) drainage fluid during the first six hours after surgery. Intracutaneous and subcutaneous drainage fluids were collected at hourly intervals from patients undergoing elective breast reduction surgery and analyzed by ELISA. Lymphocyte-specific chemokines CCL18 (> 17 ng/ml) and CCL20 (0.1 ng/ml) were detected already 2 and 1 hour respectively post wounding indicating that lymphocytes are indeed attracted in the first hours after wounding and might play an important role as early immunological effectors. A very high level of monocyte/ macrophage/ mesenchymal stem cell attracting chemokine CCL5 was also detected at 1 hour post surgery (71 ng/ml). Chemokine CCL2 was expressed at 1 hour after surgery and continued to rise during the 6 hour study period. Neutrophils chemoattractants CXCL1, CXCL8 and IL-6 peaked at 4-6 hours post surgery. Notably, chemokine gradients were detected between the two drain locations. Even though CXCL8 and IL-6 were detected in both intraand subcutaneous drainage fluids, the relative increase in production of both mediators was much more pronounced intracutaneously than subcutaneously. Also significantly higher CCL27 levels were detected in drainage fluid collected from the intracutaneous compartment compared to the subcutaneous compartment. IL-1α, TNF-α, and CXCL12 were not detected in this study. Since all donors developed normotrophic scars six months after wound closure this study describes the expression of early inflammatory mediators during normal wound healing.