260 Chapter 9 In burn wound tissue, there was a fast and extensive increase in innate immune cells that was present even in tissue debrided 3 to 4 weeks after injury. Lymphocytes also rose in numbers, but considerably late (2-4 weeks after burn injury). Cytokine composition in burn tissue was highly pro-inflammatory and likely continued the attraction and activation of immune cells. The long-lasting increase in pro-inflammatory cytokines and shifts in neutrophil and lymphocyte composition indicate that after burn injury the immune system remains in a long-term pro-inflammatory state rather than switching to a resolving state. This will in turn delay the phases of proliferation and maturation of healing wounds (Figure 2). Figure 2. Graphical summary of Part 2: Immune response in burn patients.
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