Plasma concentrations of tumour necrosis factor-α and interleukin-6 during burn wound surgery or dressing

Background: Clinical deterioration after burn wound manipulation may be related to the release of cytokines including tumour necrosis factor-α (TNF) and interleukin-6 (IL-6). Methods: The two cytokines were assayed by immunoenzymetric assay in blood samples taken before and during manipulation of th...

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Bibliographic Details
Published in:British journal of plastic surgery 1997-07, Vol.50 (5), p.354-361
Main Authors: Papini, R.P., Wilson, A.P.R., Steer, J.A., Hill, G., McGrouther, D.A., Parkhouse, N.
Format: Article
Language:English
Subjects:
Adult
Anti-Bacterial Agents - pharmacology
Bacteremia - blood
Bandages
Biological and medical sciences
Burns
Burns - blood
Burns - surgery
Burns - therapy
Double-Blind Method
Female
Gram-Negative Bacteria - isolation & purification
Gram-Positive Bacteria - isolation & purification
Humans
Interleukin-6 - blood
Male
Medical sciences
Middle Aged
Postoperative Period
Teicoplanin - pharmacology
Traumas. Diseases due to physical agents
Tumor Necrosis Factor-alpha - analysis
Tumor Necrosis Factor-alpha - drug effects
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Summary:Background: Clinical deterioration after burn wound manipulation may be related to the release of cytokines including tumour necrosis factor-α (TNF) and interleukin-6 (IL-6). Methods: The two cytokines were assayed by immunoenzymetric assay in blood samples taken before and during manipulation of the burn wound. An antibiotic, teicoplanin, was administered to half the patients at the start of the procedure in a randomized fashion as part of a separate trial. Findings: Sixty patients with a median burn size of 8% (range 1–56%) were studied during dressing change ( n = 40) or burn excision ( n = 20). There was little change in TNF levels between preoperative and recovery samples but IL-6 concentrations increased three-fold, particularly in those with large recent burns or bacteraemia, and were correlated with poor clinical outcome. The presence of teicoplanin did not significantly affect the levels of either cytokine. Interpretation: The systemic cytokine response to burn wound dressing or debridement is predominantly that of IL-6 and it is not significantly reduced by preventing Gram-positive bacteraemia during the procedure.
ISSN:0007-1226
1465-3087
DOI:10.1016/S0007-1226(97)90545-2