• M Koskela, F Gäddnäs, V Koivukangas, A Oikarinen, J Laurila, M Kallioinen, and T I Ala-Kokko.
• Department of Surgery, Oulu University Hospital, Oulu, Finland.
• Acta Anaesthesiol Scand. 2015 Sep 1; 59 (8): 1009-14.

BackgroundAn intact basement membrane at the dermal-epidermal junction is essential to the viability of the skin. The effect of sepsis on the basement membrane is unknown.MethodsSkin biopsies were used to study basement membrane structure in severe sepsis (Day 1). Subsequent biopsies were taken on Day 8 and at 3 months in the survivors. Immunohistochemical staining was undertaken using laminin-223 and type IV collagen. Twenty patients with severe sepsis and four control subjects were included in the analysis.ResultsIntensive care unit mortality was 4/20, and total 30-day mortality was 5/20. Exactly, 7/17 of patients with severe sepsis exhibited weak or absent laminin-332 expression and 11/15 exhibited weak or absent type IV collagen expression compared with 0/4 of control subjects on Day 1 in intact skin. The proportion of sepsis patients with weak or absent laminin-332 expression was 5/11 on Day 8 and fell to 1/7 at 3 months. The proportion of sepsis patients with weak or absent type IV collagen expression was 10/11 on Day 8 and 4/7 at 3 months.ConclusionThese findings suggest that basement membrane formation may be compromised in patients with severe sepsis.© 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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