Histopathological Evaluation of Burn Injury

Background: Burns always have posed a threat to the sensitive human body. It is a common catastrophe today as burn injury cases are one of the common emergencies admitted to any hospital. In a medico-legal setting, the main difficulty arises when a burnt body found in unknown circumstances is brought for post-mortem examination. In such a case, a forensic expert has to opine whether the burn injuries sustained are antemortem or post-mortem. It is also of paramount importance to determine the age of burn injuries sustained. Aging of burn injuries by the naked eye is sometimes difficult and unreliable. By histopathological examination of burnt tissue, one can predict whether the victim was alive or dead when the fire was going on and determine the age of burn injuries. Materials and Methods: The present cross-sectional study was carried out in the Department of Forensic Medicine and Toxicology, Pt. B.D.Sharma PGIMS, Rohtak. Total 3033 autopsies were conducted in the mortuary of the Department of Forensic Medicine andToxicology, PGIMS, Rohtak, from November 5, 2011`to November 5, 2013. During that period, out of 486 cases reported burns, randomly 100 cases were selected for this study. Results and Conclusions: In the present study, efforts were made to determine burn wound vitality and age by histopathological evaluation. The study revealed that the inflammatory infiltrate consisted mainly of polymorphonuclear leucocytes in initial stages (up to 3rd-day post-burn) with gradual lymphocytes, macrophages, and fibroblasts forming immature granulation tissue. On the 14th-day post-burn, the burn wound revealed repair by regeneration, increased collagen deposition, fibrosis, and granulation tissue formation. It was infiltrated with fibroblasts, macrophages, and lymphocytes. Our study demonstrated that evaluation of various histopathological changes occurring during the distinctive phases of burn wound healing help in the estimation of its vitality and age.