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Relationship between energetic, ionic, and functional status in the perfused rat heart following thermal injury: a 31P and 23Na NMR study.

To test the hypothesis that energy deficits and intracellular ion derangements may be the cellular basis for intrinsic myocardial dysfunction in rats after burn trauma, we examined ATP metabolism, intracellular pH, sodium, and mechanical performance simultaneously in perfused beating hearts from sham burn or burned rats (43% TBSA, 3 degrees scald burn, resuscitated for 24 hr with lactated Ringer's solution, Parkland formula). Intracellular calcium was also measured in myocytes harvested from parallel groups of sham burn and burn resuscitated rats. Burn trauma caused a 46% decrease in left ventricular developed pressure, a 69% decrease in +dP/dtmax, and a 72% decrease in -dP/dtmax. Intracellular to external standard sodium ratio increased (+58%) from 0.318 +/- 0.027 to 0.500 +/- 0.048 (P < 0.05), and intracellular calcium increased (+67%) from 206 +/- 13 to 445 +/- 37 nM (P < 0.01). Burn hearts exhibited decreased functional response to isoproterenol challenge compared to sham burn controls, but energy metabolism was similar in all hearts, regardless of burn injury. Our data suggest that burn trauma alters intracellular cardiomyocyte calcium and sodium homeostasis, and ionic derangements are not related to either altered intracellular pH or high energy phosphate deficits.

Adrenergic beta-Agonists↗

Altered ionic calcium and cell motion in ventricular myocytes after cutaneous thermal injury.

Cutaneous thermal injury resulting in burns covering approximately 45% of the total body surface area initiates metabolic alterations which contribute to subsequent myocardial dysfunction. Alterations in calcium homeostasis have been proposed as one mechanism by which burn injury alters organ function. This study used fura-2 and time-resolved single cell fluorescence microscopy to examine stress-related alterations in intracellular calcium in isolated adult rat cardiac myocytes. Ventricular myocytes were isolated from rats given a full-thickness scald burn comprising 43% of the total body surface area and fluid resuscitated with lactated Ringer's by the Parkland formula; control animals were included for comparison. Burn trauma caused a significant increase in cardiac myocyte maximal (peak systolic) and minimal (diastolic) mean cytosolic free calcium concentration ([Ca2+]i) transient ratios when compared to [Ca2+]i transient ratios measured in control rats. Isoproterenol application altered the time course of the [Ca2+]i transients of normal myocytes but this response was not observed in myocytes from the thermally injured rats. In addition, isoproterenol application to normal myocytes produced a significant increase in the amplitude of cell edge motion (+50%) compared to the cell edge motion measured in myocytes without isoproterenol stimulation; however, this cell motion response did not occur after isoproterenol application to myocytes from thermally injured rats. Caffeine application increased the maximal and minimal [Ca2+]i transient ratios of all myocytes, regardless of a burn injury, and the time course of the [Ca2+]i transients from the two groups appeared similar in the presence of caffeine as the myocytes progressed to contracture. Our data suggest that burn-mediated alterations in calcium homeostasis contribute, in part, to the cardiac contractile dysfunction which occurs after burn injury.

Animals↗

The effect of sequential injuries on splanchnic perfusion and eicosanoid release.

BACKGROUND: This study examines the hypothesis that sequential burn injury followed by intraabdominal sepsis induces significantly greater splanchnic hypoperfusion and reduced intestinal PGI2 release than either injury independently. MATERIALS AND METHODS: Anesthetized Sprague-Dawley rats were randomized to one of four groups: BURN (45% body surface area scald burn) + cecal ligation and puncture (CLP); BURN alone; CLP alone; or uninjured controls (SHAM). Twenty-four hours following injury, superior mesenteric artery (SMA) blood flow was measured with a doppler flow probe. Splanchnic eicosanoid release (6-keto-PGF1alpha, metabolite of PGE2; TxB2, metabolite of TxA2; and PGE2) was measured in mesenteric venous effluent utilizing an isolated, perfused bowel preparation. RESULTS: SMA blood flow was no different than that of controls 72 h following BURN injury alone; whereas CLP alone resulted in a 80% reduction in splanchnic blood flow when compared with controls (P < 0.001). SMA blood flow in animals sustaining BURN + CLP was only modestly reduced from controls (P = 0.04) and 3.6 times greater than that of animals sustaining CLP alone (P < 0.001). PGI2 was the dominant eicosanoid released by the intestine with levels 10 times greater than TxB2 and nearly 50 times greater than PGE2. CLP either alone or when combined with BURN was associated with a 60% decrease in splanchnic PGI2 release when compared to controls (P < 0.05). CONCLUSIONS: These data suggest that moderate BURN injury in rats attenuates the severe reduction in splanchnic perfusion associated with intraabdominal sepsis and that this occurs despite profound reductions in the release of the endogenous splanchnic vasodilator PGI2.

Animals↗

Recombinant human growth hormone (rhGH) downregulates hepatocyte growth factor (HGF) in burns.

INTRODUCTION: Hepatocyte growth factor (HGF) and recombinant human growth hormone (rhGH) have both been shown to increase albumin serum concentrations after major injury. However, the effect of rhGH on HGF production after injury is unknown. We postulated that rhGH effects constitutive protein concentrations by inducing HGF expression. METHODS: In order to determine a dose response, 20 male Sprague-Dawley rats received three different concentrations of rhGH 1, 2.5, and 5 mg/kg and a saline treatment. Rats were sacrificed 10 days after burn and serum albumin and HGF plasma concentrations were measured. Eighty male Sprague-Dawley rats received a 60% TBSA third-degree scald burn injury and were randomly divided into three groups, control, burn plus saline treatment, or burn plus rhGH treatment (2.5 mg/kg SQ qD). Rats were sacrificed 2, 5, 7, and 14 days after burn, and serum albumin, plasma, and hepatic tissue HGF concentrations were determined (ELISA, Institute of Immunology, Tokyo, Japan). RESULTS: At 10 days postburn serum albumin levels were significantly increased with rhGH 2.5 mg/kg treatment (P < 0.05); however, HGF plasma concentrations were significantly decreased with a dose of 5 mg/kg of rhGH compared to control and rhGH 1.0 mg/kg (P < 0.05). Serum albumin concentrations decreased immediately after burn and remained low until at least the 14th day after injury. RhGH-treated animals had higher levels of albumin on Day 7 after burn (P < 0.05). Plasma HGF levels decreased immediately after burn, but increased after the second day postburn. Beginning on the 5th day after injury, HGF levels in non-rhGH-treated rats were significantly higher compared to those in rhGH-treated rats (P < 0.05). Hepatic tissue HGF concentrations were higher in non-rhGH-treated rats compared to rhGH treated animals 7 days after burn (P < 0.01). CONCLUSION: Although rhGH treatment improves constitutive protein synthesis, rhGH decreases HGF concentration in a dose-dependent manner. The improvements in constitutive protein concentrations do not occur via a HGF dependent pathway.

Acute-Phase Reaction↗

Aspiration pneumonia-induced sepsis increases cardiac dysfunction after burn trauma.

Pneumonia occurs in approximately 50% of incubated patients in burn intensive care units and carries a mortality as high as 40%. A model was developed to study altered cardiopulmonary function in burn complicated by pneumococcal pneumonia. Sprague-Dawley rats were given a 43% total body surface area scald burn or sham burn; 24 h later they were transtracheally inoculated with either 10(7) Streptococcus pneumoniae in 0.5 ml phosphate buffer solution (PBS) or 0.5 ml PBS alone. The four groups were: Sham (N = 7), Burn alone (N = 10), Pneumonia alone (N = 11), and Burn and Pneumonia ( N = 12). A fifth group of burned rats (N = 10), given an identical fluid resuscitation regimen, was sacrificed 24 h postburn to examine the early cardiac responses to burn injury alone. Shams and burned animals had normal lung histology, negative bronchoalveolar lavage (BAL) cultures, and negative blood cultures. Pneumonia and burn plus pneumonia animals had abnormal lung histology, positive BAL cultures, and positive blood cultures. Cardiac function was assessed 24 h after S.pneumoniae challenge (48 h after burn) (Langendorff preparation). Compared to the Sham group, Pneumonia group, and Burn group, the Burn plus Pneumonia group had the lowest left ventricular pressure (LVP: 94 +/- 4, 71 +/- 3, and 87 +/- 3 mm Hg vs 63 +/- 4 mm Hg, P < 0.05), the lowest maximal rate of LVP rise (+dP/dt[max]:1932 +/- 115, 1419 +/- 71, and 1772 +/- 96 mm Hg vs 1309 +/- 59 mm Hg/s, P < 0.05), and the lowest maximal rate of LVP fall (-dP/dt[max]:1704 +/- 120, 1263 +/- 73, and 1591 +/- 83 mm Hg vs 1025 +/- 98 mm Hg/s, P < 0.05). Cardiac contraction and relaxation deficits were confirmed in animals 24 h postburn (group 5), as indicated by a significantly lower LVP and +/-dP/dt(max) (62 +/- 3 mm Hg 1210 +/- 60, and 909 +/- 50 mm Hg/s, respectively, P < 0.05 compared to Sham group). Tumor necrosis factor-alpha (TNF-alpha) concentrations in serum, but not bronchoalveolar lavage, were greater in burned animals with aspiration pneumonia-induced sepsis than in animals with either burn alone or aspiration pneumonia-induced sepsis alone. While our data suggest that elevated circulating TNF-alpha levels may contribute, in part, to depressed cardiac function, further studies are needed to fully define the mechanisms underlying cardiac contractile deficits in this model. We speculate that depressed cardiopulmonary function due to burn complicated by pneumonia and sepsis contributes to the high mortality of this patient population.

Animals↗

Acetylcholine-induced and nitric oxide-mediated vasodilation in burns.

Microvascular endothelial cells actively participate in local regulation of blood flow and blood-tissue exchange by producing various vasoactive substances including nitric oxide (NO). This study examined microcirculatory changes in the early stage of thermal injury and the NO-related mechanisms. Resistance arterioles of rat cremaster muscle were observed using intravital microscopy. Arteriolar diameter and flow velocity were measured and flow rate was calculated after administration of various vasoactive agonists in burns. In fluid-resuscitated rats with stable systemic blood pressure, microvascular caliber and blood flow were not significantly altered in the first hour following a 25% total body surface area full-thickness scald burn. Topical application of acetylcholine (ACh), an endothelium-dependent vasodilator, increased arteriolar diameter and flow rate in a dose-dependent fashion. The dose-responsive effects of ACh were significantly greater in burned rats than in sham-burned rats, and the augmentation was blocked by inhibition of NO production with NG-monomethyl-l-arginine (L-NMMA). Topical application of adenosine, an endothelium-independent vasodilator, and sodium nitroprusside, an exogenous NO donor, markedly increased arteriolar diameter and flow rate. The effects were not significantly different in burned and sham-burned animals, and the adenosine-induced vasodilation was not blocked by L-NMMA. These data suggest that endothelium-dependent and NO-mediated arteriolar dilation is enhanced in the early stage of thermal injury. This effect may play an important role in the pathophysiological events of microcirculation and blood-tissue exchange in burns.

Acetylcholine↗

Thermal injury alters myocardial sarcoplasmic reticulum calcium channel function.

BACKGROUND: We have previously shown that a major cutaneous thermal injury produces profound cardiac contractile dysfunction despite adequate resuscitation. While the molecular basis of this dysfunction is unknown, recent work has suggested that alterations in calcium flux between the myocyte sarcoplasmic reticulum (SR) to the cytoplasm may play a role. MATERIALS AND METHODS: To determine if thermal injury-induced contractile dysfunction is related to intracellular calcium transport across the SR membrane, we accessed myocardial microsomal preparations from scalded (43% TBSA) guinea pigs for the ability of the cardiac calcium efflux channel to bind radiolabeled ryanodine. Intracellular calcium flux was assessed by fluorescence spectrophotometry. RESULTS: Thermal injury resulted in severe cardiac contractile deficit characterized by loss of LVP and +/-dP/dt despite resuscitation. Analysis of isolated myocyte cultures showed a twofold increase in cytoplasmic [Ca2+]l by 24 h postburn. Competitive binding and Scatchard analysis demonstrated a single, high-affinity binding site present in both sham and burn animal hearts. Myocardial membrane vesicles revealed a significantly enhanced number of calcium efflux channels in the open configuration at both 8 and 24 h following thermal injury compared to time-matched shams (1.07 +/- 0.01 and 0.95 +/- 0.06 vs 0.85 +/- 0.01 pmol bound/mg protein, P < 0.05). The data indicate that altered function of the myocardial transmembrane SR calcium efflux channel following thermal injury was associated with elevated [Ca2+]l and contractile dysfunction. CONCLUSIONS: We conclude that postburn cardiac dysfunction may partly be a result of elevated cytoplasmic calcium concentrations and diminished regulation of SR calcium efflux channel activity.

Animals↗

Recombinant human growth hormone alters acute phase reactant proteins, cytokine expression, and liver morphology in burned rats.

BACKGROUND: The effects of exogenous recombinant human growth hormone (rhGH) on hepatic acute phase reactant proteins, cytokine expression, and liver morphology were studied in thermally injured rats to define whether rhGH alters the acute phase response. MATERIALS AND METHODS: Sprague-Dawley rats (56 males) receiving a 60% TBSA third-degree scald burn were randomly divided into two groups to receive either 2.5 mg/kg/day sc rhGH or saline. Rats were sacrificed on Postburn Days 1, 2, 5, and 7. Serum acute phase reactant proteins and cytokines TNF-alpha, IL-1alpha, IL-1beta, and IL-6 were measured. Hepatocyte proliferation, hepatic cytokine gene expression, and liver protein concentrations were determined. RESULTS: Recombinant hGH increased serum albumin on Days 5 and 7 after burn (P < 0.05). Serum haptoglobin and alpha1-acid glycoprotein levels decreased at 2, 5, and 7 days after burn compared to saline (P < 0.05). In rats treated with rhGH, serum IL-1beta decreased 1 day postburn, while serum TNF-alpha increased 5 days after burn compared to saline (P < 0.05). Serum IL-6 and IL-1alpha did not change. Hepatic RNA levels for TNF-alpha were significantly elevated on Day 1 postburn compared to saline (P < 0. 05). Hepatic protein content increased on Days 2, 5, and 7 postburn compared to saline (P < 0.05). Hepatocyte proliferation in rhGH-treated rats increased on Day 5 after burn (P < 0.05). CONCLUSION: Data indicate that rhGH alters the hepatic acute phase response by decreasing type I acute phase proteins and modulating IL-1-like cytokine expression. These changes are associated with increased hepatocyte mitosis and serum and total liver protein concentrations.

Acute-Phase Proteins↗

Increased expression of insulin-like growth factor-I in serum and liver after recombinant human growth hormone administration in thermally injured rats.

BACKGROUND: Recombinant human growth hormone (rhGH) has been shown to modulate the hypermetabolic response and the hepatic acute-phase response after thermal injury. In vitro studies, however, demonstrated that rhGH activates insulin-like growth factor-I (IGF-I) gene transcription and production, suggesting that rhGH may exert some of its effects indirectly through IGF-I stimulation. The purpose of this study was to determine the effects of rhGH on serum and hepatic IGF-I in thermally injured rats. METHODS: Sprague-Dawley rats (56 males) receiving a 60% TBSA third-degree scald burn were randomly divided to receive either rhGH (2.5 mg/kg/day im) or saline (control). Rats were sacrificed on postburn days 1, 2, 5, and 7 and serum IGF-I, hepatic IGF-I mRNA, and IGF-I protein concentration were measured. The physiologic response to changes in IGF-I levels was evaluated by measuring hepatocyte proliferation, total liver protein concentration, and muscle dry/wet weights. RESULTS: Serum IGF-I was increased from postburn day 1 through day 7 in rats receiving rhGH compared to controls (P < 0.05). Hepatic IGF-I mRNA and IGF-I protein expression were increased from day 1 to 7 after burn in animals receiving rhGH when compared to controls (P < 0.05). Recombinant hGH increased hepatocyte proliferation at 5 days and total liver protein concentration at 5 and 7 days postburn compared to controls (P < 0.05). Muscle dry/wet weights increased in rats receiving rhGH at 7 days after burn compared to controls (P < 0.05). SUMMARY: Liver and serum IGF-I levels decreased after a thermal injury. Recombinant hGH attenuated this decrease by stimulating hepatic IGF-I expression. Increases in IGF-I were associated with increases in hepatocyte proliferation and protein concentration in liver and muscle. CONCLUSION: We suggest that rhGH modulates the hypermetabolic response through IGF-I stimulation in the hepatic parenchyma.

Animals↗

Dynamics of tissue neutrophil sequestration after cutaneous burns in rats.

BACKGROUND: Neutrophil recruitment in organs after burns may cause local vascular damage, which can be reduced by agents blocking neutrophil adhesion to the vascular wall. Because these agents may increase susceptibility to infection, it is important to characterize the dynamics of neutrophil sequestration in order to optimize an eventual anti-adhesion therapy. MATERIALS AND METHODS: Rats were scald burned over 20 or 40% of their total body surface area (TBSA) and saline resuscitated. Sham controls were used. Myeloperoxidase (MPO) activity was measured in lungs, liver, kidney, gut, and burned skin up to 1 week postburn. Extravascular accumulation of (125)I-labeled bovine serum albumin ((125)I-BSA) was measured at 12 h postburn. RESULTS: MPO activity in lungs, liver, and kidney was increased within 3 h postburn and returned to normal within 24-48 h. Peak MPO levels occurred at 6-12 h postburn and were similar for both burn sizes. No MPO increase was observed in gut. MPO levels in burned skin did not increase before 6 h, peaked at 24 h, decreased at 48 h, but remained elevated for up to 7 days. Neutrophil recruitment in lungs and liver was confirmed histochemically. No neutrophils were found in kidneys. Extravascular (125)I-BSA was increased in lungs, liver, kidneys, and gut, in the 40% TBSA group only. CONCLUSIONS: Neutrophil sequestration in remote organs is a transient phenomenon while neutrophil homing into the wound site is sustained. Neutrophil accumulation dynamics are independent of burn size, although a minimum size is required to trigger vascular damage. Temporary early anti-adhesion therapy to reduce lung and liver neutrophil sequestration with little impact on neutrophil homing into the burn wound may be possible.

Animals↗

Insulin suppresses the increased activities of lysosomal cathepsins and ubiquitin conjugation system in burn-injured rats.

BACKGROUND: Burn injury results in increased rate of skeletal muscle protein degradation. In vitro studies on incubated muscles indicate that increased rate of protein degradation is due to activation of multiple proteolytic systems, but the supporting evidence is of an indirect nature. The present study was carried out to investigate the role of various lysosomal cathepsins, ubiquitin conjugation, and proteasome systems in accelerated proteolysis, and the effect of insulin in burn-induced muscle wasting syndrome. MATERIALS AND METHODS: Fifteen to twenty percent total body surface area scald burn injury was inflicted on the shaved dorsum of young growing rats. Insulin-treated rats received a daily single subcutaneous injection for 3 days (0.25-1.0 U/day). The rate of ubiquitin conjugation to endogenous proteins and exogenously added (125)I-lysozyme and the activities of various proteases were measured in muscle homogenates. RESULTS: Burn injury resulted in increased rate of ubiquitin conjugation to endogenous proteins and (125)I-lysozyme. Activities of cathepsins B, C, H, and L were also up-regulated following burn injury. When the burn-injured rats were treated with insulin, the increased rate of ubiquitin conjugation and cathepsin activities were suppressed to the control levels. CONCLUSIONS: The increased ubiquitin conjugation and lysosomal cathepsins contribute to accelerated protein degradation in burn-injured rats and insulin suppresses the muscle protein degradation at least in part by suppressing the activities of lysosomal cathepsins and of ubiquitin conjugation system.

Adenosine Triphosphate↗

Antiproteolytic action of insulin in burn-injured rats.

BACKGROUND: Negative nitrogen balance is a typical metabolic response to burn injury resulting in decreased muscle mass and activity. Since insulin is an anabolic hormone, using insulin as a prophylactic agent in burned patients has received some attention. The present study was carried out to investigate the systemic effect of insulin on burn injury-induced muscle wasting. PATIENTS AND METHODS: A 15-20% total body surface area (TBSA) scald burn injury was inflicted on the shaved dorsum of rats. Rats were treated with a daily subcutaneous insulin injection for 3 days (0.25-1.0 U/day). After the treatment, a variety of insulin-dependent physiological parameters were monitored. Overall body protein degradation rates were determined by measuring the urinary tyrosine. Also, protein degradations were measured in diaphragm muscles, splenocytes, and peripheral blood mononuclear cells to directly confirm the antiproteolytic activity of insulin. RESULTS: Administration of insulin to burn-injured rats restored body weight primarily by reducing accelerated protein degradation and regaining the intracellular protein content in individual skeletal muscle. The measured physiological parameters showed no possible side effects. Protein degradation in immune cells was also suppressed after the therapy. CONCLUSION: Results indicate that lower dose insulin particularly suppresses protein degradation without causing secondary effects. It may be a useful approach to preventing burn injury-induced muscle wasting and also has a potential to improve immune response.

Animals↗

Parabiotic demonstration of a substance released from burned tissue affecting marrow megakaryocyte diameter and number in mice.

Four groups of C3H mice were studied to determine effects of substances released into blood from burned tissue on platelet counts and megakaryocyte numbers and sizes. Burns were full thickness scald injuries over 20% of body. Groups were: 1) Single, non-burned (controls); 2) Single, burned; 3) Parabiosed non-burned; 4) Parabiosed, one burned in each pair. Platelet counts and megakaryocyte counts and sizing were done at sacrifice. On 2nd postburn day platelet counts of group 4 were significantly lower (P less than 0.0005) than in group 1, but higher than in group 2. On day 5 platelet counts of group 4, returned to normal, then rose above normal. Two to five days postburn, megakaryocyte diameters were significantly larger in groups 2 and 4. Fifty megakaryocytes from each mouse of treatment groups were measured. A blood-borne substance(s) derived from burned tissue appears responsible for waning and waxing of megakaryocyte activity.

Animals↗

An apple polyphenol oxidase cDNA is up-regulated in wounded tissues.

A full-length cDNA clone encoding apple (Malus domesticus) polyphenol oxidase (PPO) was isolated from a fruit peel cDNA library. Southern analysis indicated that apple PPO is encoded by a divergent multigene family. By northern analysis, PPO mRNA was only detected in a fruit sample taken one week after full bloom. PPO mRNA accumulated in wounded tissues, and also in peel tissue showing the symptoms of superficial scald, a post-harvest disorder. The induction of PPO mRNA provides the first evidence for transcriptional control of PPO expression after wounding or the manifestation of a physiological disorder.

Catechol Oxidase↗

The effect of a collagen dressing on contaminated surgical wounds in rats.

In maintaining the rat, the collagen dressings, Aviderm Amine and Aviderm, are as effective as skin in low bacterial levels in contaminated surgical wounds. In the scald-burn wound in the rat the effect of skin dressing is confirmed. Also, 48 h after collagen dressing in the wound the bacterial contamination was the same as that seen under autograft dressings. We have elsewhere suggested that skin and some other dressings modify the local host defense by their effect on the accumulated white blood cells. We believe that collagen, as well as some synthetics, can alter the local environment permitting the destruction of invading bacteria by the accumulated white blood cells.

Animals↗

Prevalence of smoke detectors and safe tap-water temperatures among welfare recipients in Memphis, Tennessee.

The poor are at high risk for fire- and scalding-related injuries and deaths, many of which could be prevented by installing smoke detectors and reducing residential tap-water temperatures to safe levels. The goal of this study was to measure the prevalence of smoke detectors and safe tap-water temperatures among welfare recipients and compare subjects living in safe and unsafe homes. We interviewed 109 black women residing in inner-city Memphis who were receiving Aid to Families with Dependent Children and inspected their homes for functional smoke detectors and safe tap-water temperatures. Of the 533 residents reported to live in the homes visited for this study, 53.1% were not protected by smoke detectors. More crowded residences were substantially more likely to lack detectors. Most of the smoke detectors which were present were provided by landlords. Of 69 smoke detectors examined, 17.4% did not work. Of the 153 children age 0-5 years living in the homes we visited, 79.1% lived in residences with excessively hot tap water (> 54 degrees C). We conclude that additional efforts are needed to increase the use of smoke detectors and to decrease excessively hot tap water in the homes of welfare recipients.

Adolescent↗

Principles and procedures in female breast reconstruction in the young child's burn injury.

Thermic lesions of the neck, the shoulder, and the thoracic wall in young children are characterized by identical etiology, pathology, and prognosis. Scald injuries from hot liquids cause deep second-degree up to superficial third-degree burns. In these injuries the subcutaneously located mammary gland is not affected. Therefore, the severe deformities that may occur in puberty are only defects of the soft tissue coverage and not of the mammary glands. Radical scar excision and skin grafting is the therapy of choice. Z-plasty and local flaps may correct these burn defects only partially because the loss of tissue is compensated only by a new distribution of the adjacent skin areas.

Accidents, Home↗

Effects of granulocyte colony-stimulating factor on bacterial translocation due to burn wound sepsis.

The presence of certain defects in both cellular and humoral immunity after thermal injury has been established. Likewise, the translocation of enteric bacteria to the mesenteric lymph nodes and to distant organs has also been observed following serious thermal injury. The effects of granulocyte colony-stimulating factor (G-CSF) on bacterial translocation, the small bowel mucosa, and cecal bacterial content were investigated in a rat model of burn wound sepsis in which albino Wistar rats were scalded over 30% of their bodies, after which the lesions were infected by 1 x 10(8) colony-forming units (cfu) Pseudomonas aeruginosa. The control group was treated with 5% dextrose solution subcutaneously starting 2 days preburn, while the treatment group received 100 microg/kg human G-CSF subcutaneously. On the 4th day post burn all animals were killed to examine the bowel and culture of the mesenteric lymph nodes (MLN), livers, and spleens. No significant differences were observed between the groups regarding the cecal bacterial content and small bowel; however, a difference was seen in the ratio of translocation in the MLN liver and spleen and quantitative MLN cultures. Based on these findings, G-CSF was thus found to be significantly effective in reducing bacterial translocation due to burn wound sepsis.

Animals↗