Korean J Anesthesiol.  2003 Aug;45(2):232-237. 10.4097/kjae.2003.45.2.232.

The Effect of Early Escharectomy on Pro- and Antiinflammatory Cytokines in Major Burn Patients

• Moon J
• Hur J
• Chun S
• Kim J
• Park S
• Kwon J
• Woo C
• Kwak I
• Han T
• Kim K

• KMID: 2236720
• DOI: http://doi.org/10.4097/kjae.2003.45.2.232

Abstract

BACKGROUND: Early escharectomy has been shown to improve survival rates and treatment outcomes in major burn patients. However, its mechanism, especially in human immune systems, has not been fully elucidated. This observational study, focusing on cytokines, was conducted to assess changes in the levels of tumor necrosis factor alpha (TNF alpha) and interleukin-10 (IL-10) in major burn patients that underwent early tissue excision.
METHODS
Seventeen ASA physical status II or III adults major burn patients, admitted to general surgery for burn wound care, were initially recruited. When early escharectomy was scheduled, a series of blood samples was obtained four times at 72 and 24 hours preop and at 24 and 72 hours postop. Changing levels of TNF alpha and IL-10 were measured by quantitative sandwich immnuoassay.
RESULTS
Subjects suffered from 70% TBSA burns. Both cytokines demonstrated a significant tendency to increase in the blood during the study period. Although they temporarily decreased 24 hours after surgery, this effect did not last.
CONCLUSIONS
Burn injury certainly increases cytokine response. Early escharectomy appears to decrease the pro and anti-inflammatory cytokines only temporarily. It did not seem to have any long term effect in the human immune system in major burn patients, probably due to the complex nature of the injury.

Keyword

cytokines; escharectomy; major burn

MeSH Terms

Adult
Burns*
Cytokines*
Humans
Immune System
Interleukin-10
Observational Study
Survival Rate
Tumor Necrosis Factor-alpha
Wounds and Injuries
Cytokines
Interleukin-10
Tumor Necrosis Factor-alpha