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

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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.

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Acknowledgments

The authors thank Mrs. Dominique Meng, Mrs. Arielle Chapelet, Mr. Alain Behm, and all the team of the Department of Pathology (Hôpital Central, CHU Nancy) for technical support and Mrs. Jacqueline Zevnick and Dr Jonathan Hayes for reviewing the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, CHU Nancy, Nancy, France

    Guillaume Gauchotte, Marie-Pierre Wissler, Jean-Matthieu Casse, Charlène Vigouroux, François Plénat & Jean-Michel Vignaud

  2. Faculty of Medicine, INSERM U954, Nancy, France

    Guillaume Gauchotte & Jean-Michel Vignaud

  3. Department of Maxillofacial and Plastic Surgery, CHU Nancy, Nancy, France

    Julien Pujo, Christophe Minetti & Héloïse Gisquet

  4. Department of Legal Medicine, CHU Nancy, Nancy, France

    Laurent Martrille

  5. Service d’Anatomie et Cytologie Pathologiques, Hôpital Central, CHU de Nancy, 29, avenue du Maréchal de Lattre de Tassigny, 54000, Nancy, France

    Guillaume Gauchotte

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  1. Guillaume Gauchotte
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  2. Marie-Pierre Wissler
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  3. Jean-Matthieu Casse
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  6. Héloïse Gisquet
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  7. Charlène Vigouroux
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  9. Jean-Michel Vignaud
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  10. Laurent Martrille
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Correspondence to Guillaume Gauchotte.

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Jean-Michel Vignaud and Laurent Martrille contributed equally.

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Gauchotte, G., Wissler, MP., Casse, JM. et al. FVIIIra, CD15, and tryptase performance in the diagnosis of skin stab wound vitality in forensic pathology. Int J Legal Med 127, 957–965 (2013). https://doi.org/10.1007/s00414-013-0880-1

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  • DOI: https://doi.org/10.1007/s00414-013-0880-1

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