International Journal of Legal Medicine

, Volume 127, Issue 5, pp 957–965

FVIIIra, CD15, and tryptase performance in the diagnosis of skin stab wound vitality in forensic pathology

Authors

    • Department of PathologyCHU Nancy
    • Faculty of MedicineINSERM U954
    • Service d’Anatomie et Cytologie PathologiquesHôpital Central, CHU de Nancy
  • Marie-Pierre Wissler
    • Department of PathologyCHU Nancy
  • Jean-Matthieu Casse
    • Department of PathologyCHU Nancy
  • Julien Pujo
    • Department of Maxillofacial and Plastic SurgeryCHU Nancy
  • Christophe Minetti
    • Department of Maxillofacial and Plastic SurgeryCHU Nancy
  • Héloïse Gisquet
    • Department of Maxillofacial and Plastic SurgeryCHU Nancy
  • Charlène Vigouroux
    • Department of PathologyCHU Nancy
  • François Plénat
    • Department of PathologyCHU Nancy
  • Jean-Michel Vignaud
    • Department of PathologyCHU Nancy
    • Faculty of MedicineINSERM U954
  • Laurent Martrille
    • Department of Legal MedicineCHU Nancy
Original Article

DOI: 10.1007/s00414-013-0880-1

Cite this article as:
Gauchotte, G., Wissler, M., Casse, J. et al. Int J Legal Med (2013) 127: 957. doi:10.1007/s00414-013-0880-1

Abstract

The timing of skin wounds is one of the most challenging problems in forensic pathology. In the first minutes or hours after infliction, histological examination fails to determine whether a wound was sustained before or after death. The aim of this study was to evaluate the use of three immunohistochemical markers (FVIIIra, CD15, and tryptase) for the interpretation of the timing of cutaneous stab wounds. We evaluated these markers in intravital wounds from autopsy cases (n = 12) and surgical specimens (n = 58). As controls, we used normal skin samples from autopsies (n = 8) and an original ex vivo surgical human model of recent postmortem wounds (n = 24). We found overexpression of FVIIIra in 100 % of vital wounds, but also in 53 % of the controls. The number of CD15-positive cells was higher in wound margins than in internal controls (p < 0.0001) and was significantly correlated with the time interval between incision and devascularization (p = 0.0005; minimal time for positivity, 9 min). Using the anti-tryptase antibody, we found that the mast cell degranulation rate was higher in wound margins (p < 0.0001) and correlated with the time interval (minimal time, 1 min). The sensitivity and specificity for the diagnosis of vitality were respectively 100 and 47 % for FVIIIra, 47 and 100 % for CD15, and 60 and 100 % for tryptase. The inter-observer agreement coefficients were 0.68 for FVIIIra, 0.90 for CD15, and 0.46 for tryptase. Finally, we demonstrated that these markers were not reliable in putrefied or desiccated specimens. In conclusion, CD15 and tryptase, but not FVIIIra, may be useful markers for differentiating recent antemortem from postmortem injuries.

Keywords

FVIIIraCD15TryptaseWoundVitalityForensic

Copyright information

© Springer-Verlag Berlin Heidelberg 2013