Don’t Miss This: The Epithelial Light Reflex

Earlier this week I was showing a patient that, while his wound might look like it was still open, in fact, most of it was covered with skin. When the epithelial cells first migrate, they are translucent and you have to get the light at an angle to determine whether there is actually “skin” over the wound. As the epithelium matures, it is more difficult to see the pink blood vessels below, and the melanin pigment usually activates.

Here are two examples of this – the same wound from slightly different angles – demonstrating epithelium. You do NOT want to accidentally traumatize this new skin. (And you can tell the wounds are nearly closed by the amount of drainage they have – which should be pretty small.)

Here’s another example in which from one angle of the light the wound looks open, but when you get the light from a different angle you can see that there’s skin over the wound: