Surface chemistry by blotting the skin & wound for prediction and diagnosis: a systematic review

Dr Katie Wang1, Dr Patrick Daly2, Dr Chris Lau2, Dr Aoife  O’Brien2, Ms Cheryl  Hamill2, Dr Guy  Stanley2, Professor  Fiona Wood2

1Royal Perth Hospital, Perth, Australia, 2Fiona Stanley Hospital, Perth, Australia


Introduction: The skin performs important structural and physiological functions, and skin assessment represents an important step in the diagnosis and prognosis of pathology. Although many non-invasive techniques for assessing skin status exist, a novel assessment tool, involving ‘blotting’ the skin or a wound’s surface chemistry, has seen increasing experimental use. Burn injuries represent extreme forms of skin injury, and pathological scars have undesirable consequences. This review explores the utility of blotting in the diagnosis and prediction of skin pathophysiology, and how this translates as a tool for burns.

Methods: Following the submission of the protocol to the database, the systematic review was conducted adhering to the PRISMA 2020 guidelines.

Results/Discussions: Through a comprehensive search of the last 15 years, 40 papers were identified and illustrated preliminary insights into:
(A) Blotting as a non-invasive tool: variations in the technique; reliability and accuracy of the results; and biomarkers that blotting is sensitive to.
(B) Blotting and its translational relevance: assessment of skin physiology; the various skin diseases blotting has been utilised for; and the relationship between blotting biomarkers with diagnosis/prognosis of skin diseases.

Conclusion: Our review summarises the literature to date on blotting. It demonstrates that non-invasive blotting of the skin surface chemistry is a technique with the potential to translate into clinical practice. It raises opportunities to expand utilisation to burns and other skin diseases; be used as an adjunct to clinical assessment; and has a role as an objective diagnostic and/or prognostic bedside tool.


Katie is an intern at Royal Perth Hospital who is a member of the Burns Research Group at Fiona Stanley. She has a strong interest in plastic surgery following the completion of her elective at Royal Free Hospital in London. During her studies, Katie has undertaken various research projects involving the breast microbiota and surgical medical devices.

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