Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Surgical Trauma”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1996

The role of lactulose in the prevention of bacterial translocation in surgical trauma.

Surgical trauma (ST) is one of the causative factor of bacterial translocation. In this study we investigated the prevention of bacterial translocation with lactulose in a surgical trauma model. The study was designed in 3 experimental groups consisting of 15 rats in each. Group 1 was sham operated controls, group 2 was ST + physiologic saline treated and group 3 was ST + lactulose treated animals. Lactulose and physiologic saline were given by oro-gastric intubation in a dose of 2 ml of 33.5% solution/d and 2 ml/d respectively starting 3 days prior to surgery. Bacterial translocation was investigated 48 hours after the operations. In sham operated controls only 1 bacterial translocation to the mesenteric lymph nodes (MLN) was observed. In the ST + physiologic saline treated group bacterial translocation to the MLN and portal venous blood (PVB) were significantly increased compared with both sham operated controls and the ST + lactulose treated group (p < 0.001). In rats with lactulose treatment the results of caecal bacterial counts showed a significant decrease in the number of gram-negative aerobes and facultative anaerobe bacteria (p < 0.01) and a significant increase in the number of lactobacilli (p < 0.001) compared to the sham operated controls. Measurement of the mucosal height showed a significant increase at the terminal ileum and the caecum compared with the sham operated controls and the surgical trauma+physiologic saline treated group (p < 0.001). We conclude that oral lactulose treatment 3 days prior to the surgical trauma, reduced the incidence of bacterial translocation to the MLN and PVB.

Animals↗
PubMed1991

[Patient's reaction to surgical trauma in surgical treatment of duodenal ulcer].

Evaluation of metabolism and state of central hemodynamics in 134 patients with duodenal ulcer before the operation and at the early postoperative period was carried out. It was established that pronouncement of postaggressive response of an organism to trauma in surgical treatment of a duodenal ulcer didn't depend on a type of the operation due to use of the modern methods of anesthesia. Therefore, moderate pronouncement of such a response after the organ-preserving operations can't be a criterium for the wide use of surgical treatment of an uncomplicated duodenal ulcer.

Adult↗
PubMed1993

Role of tissue glutathione in prevention of surgical trauma.

1. Surgical trauma has been associated with pre-anaesthesia fasting, anaesthetic toxicity, haemorrhage, hypovolaemic shock, and other pathological phenomena. Tissue glutathione (GSH), thiobarbituric acid-reacting substances (TBAR), and radical-trapping activity (RTA) have been determined at various time intervals after fasting, anaesthesia, and also after hepatic ischaemia and reperfusion as a model for haemorrhage and hypovolaemic shock. 2. Light ether anaesthesia of rats resulted in an immediate (5 min) and progressive decrease in liver and kidney total glutathione (GSH and GSSG), which was much greater in animals that had been fasted for 20 h. TBARs, a measure of lipid peroxidation, in rat liver and kidney increased as total GSH decreased. Fasting (20 h) alone decreased tissue GSH by 50%, and increased TBAR 100%; fasting plus 30 min of ether anaesthesia decreased tissue glutathione by 80 to 85%, and increased TBAR by some 600%. 3. Liver ischaemia alone decreased total liver GSH by 20% in the fed rat, and 50% in the fasted rat. Ischaemia, followed by reperfusion, decreased liver total GSH by 70% in the fed rat, and 90% in the fasted rat. The ratio of GSH/GSSG decreased from 16 in control animals to 7 in the fasted ischaemic rat, then to 1 in the fasted, ischaemic rat reperfused for 90 min. RTA of liver closely paralleled liver total GSH levels. TBAR was increased by ischaemia alone (50-100%), but more (400%) by 90 min reperfusion. 4. A complex series of molecular mechanisms including: (1) GSH depletion; (2) induction of CYP2E1 activity; (3) generation of reactive oxygen species; (4) lipid peroxidation; (5) cytokine release; and (6) leucocyte activation, are advanced to account for the toxic phenomena of surgical trauma and multiple system organ failure.

Animals↗
PubMed1995

[Postoperative homeostatic imbalance after trauma surgical interventions of various degrees in polytrauma].

The objective of this study was to evaluate and compare the derangement of body homeostatis and the inflammatory response after different types of traumatological operations in patients with multiple injuries. These were determined in a total of 60 operations. The procedures comprised osteosynthesis of the femur (n = 28), the pelvic girdle (n = 11) the spine (n = 8), and facial and basal skull reconstructions (n = 13). Specific and unspecific parameters of the inflammatory response were determined on the morning of the operation, immediately after the procedure, every 6 h on the 1st day and 48 h after the end of surgery. After all types of operations (pelvis, femur, spine, face/basal skull) significant alterations were observed for neutrophil elastase, C-reactive protein, interleukin 6, interleukin 8, antithrombin III, partial thromboplastin time and other parameters. The degree of postoperative changes differed significantly (Kruskal-Wallis test, P < 0.05) among the four types of operations for lactate, heart rate, PO2/FiO2 ratio and nitrogen excretion and showed a strong discriminating tendency for neutrophil elastase and C-reactive protein. The changes were most pronounced after operations on the pelvic girdle, followed by procedures in the femoral, spinal, and facial/basal skull regions. We conclude that a considerable inflammatory response and pronounced disturbance of body homeostasis follow traumatological operative procedures, varying in severity with the type of surgery. Several parameters allow quantitation of the surgical trauma and differentiation between different operations/regions. Further research should focus on the interrelationship between pre-existing preoperative inflammation and the additional trauma inflicted by surgery in patients with severe injuries.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute-Phase Reaction↗
PubMed2001

Glomerular permeability after surgical trauma in children: relationship between microalbuminuria and surgical stress score.

OBJECTIVES: To determine whether there is an increase of urinary albumin during and after surgical trauma and investigate a possible relationship between microalbuminuria and the severity of surgical stress. DESIGN: Prospective study. SETTING: University hospital pediatric intensive care unit. PATIENTS: Forty consecutive children scheduled for elective surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Microalbuminuria/urinary creatinine ratio (MACR) was measured before, during, and after elective moderate or major surgical procedures. The Oxford Surgical Stress Score (SSS) was determined for each patient at the end of the operation, and its relationship with maximum deviation of MACR from baseline values was investigated. MACR showed a progressive increase during surgery and a decrease afterward, reaching preoperative values in most cases within 24 hrs after the end of surgery. There was a significant correlation between the increase in MACR and severity of the surgical trauma as measured by SSS. Two patients showed a rise in MACR after the initial postoperative normalization before clinical appearance of a surgical complication and one patient showed a persistent rise in MACR before clinical appearance of a septic complication. None of the other patients showed any rise in MACR after postoperative normalization, and they all had an uneventful recovery. CONCLUSIONS: MACR rises during and after major or moderate elective surgery in children. There is a significant positive correlation between severity of surgical trauma and capillary permeability in pediatric patients. Microalbuminuria, as an index of capillary permeability, may be an early sign of incipient complications and assist in the identification of those patients whose condition will deteriorate. The test is a cheap, blood-sparing, easy-to-perform bedside procedure that may have a useful role in clinical practice for evaluating the effect of surgical trauma on capillary permeability in children.

Albuminuria↗
PubMed1980

Circadian periodicity of plasma corticosterone levels in rats subjected to hemorrhagic shock and surgical trauma.

The effects of surgical trauma and hemorrhagic shock on the circadian rhythmicity of corticosteroid secretion in the rat were investigated. The estimations were performed at 4-hour intervals for a 24-hour period. Control animals exhibited a characteristic circadian rhythm of plasma corticosterone with peak concentrations occurring at 8 p.m. followed by a gradual fall during the night, reaching a minimum at 8 a.m. Severe stress induced by hemorrhagic shock or surgical trauma caused a dramatic alteration in corticosterone rhythms which persisted up to 72 h following surgery or hemorrhage. It is apparent that the physiological mechanisms which regulate adrenal rhythmicity are disrupted for a prolonged period following major stress or trauma.

Animals↗
PubMed1998

Evaluation of neutrophil functions after experimental abdominal surgical trauma.

OBJECTIVE: In order to determine the effect of surgical trauma on neutrophil functions, we set up an experimental abdominal surgical model using rats and analyzed neutrophil functions. In addition, we measured tumor necrosis factor-alpha (TNF-alpha), cytokine-induced neutrophil chemoattractant/growth-regulated oncogene (CINC/GRO) and nitric oxide (NO) production. MATERIALS AND METHODS: Male Sprague-Dawley rats, 8 weeks old and weighing 250-270 g, underwent laparotomy (4 rats for each experiment). After the operation, neutrophil chemotaxis was assayed using a modified Boyden chamber, and phagocytosis, active oxygen production and adhesion molecule expression were analyzed by flow cytometry. TNF-alpha and CINC/GRO levels were quantified by an immuno-dot-blot assay, and NO levels were measured by the Griess method. At the operation, NO inhibitor, N(G)-monomethyl-L-arginine acetate (L-NMMA, 40 mg) was intraperitoneally administered, and the effect of L-NMMA was studied. RESULTS: After the surgical trauma (24-48 h), blood neutrophil counts significantly increased (p < 0.001), and neutrophil chemotaxis, phagocytosis and active oxygen production were markedly enhanced (p < 0.01). Moreover, up-regulation of Mac-1 and down-regulation of L-selectin on neutrophils were observed (p < 0.05). The levels of TNF-alpha, CINC/GRO and NO increased remarkably in both blood and ascites at 8-48 h after the surgical trauma (p < 0.01): TNF-alpha increased from 194 +/- 9 (the mean +/- SD, n = 4) and 183 +/- 12 pg/ml (preoperation) to 797 +/- 28 and 1045 +/- 137 pg/ml at 24 h in blood and ascites, respectively; CINC/GRO increased from 0.1 +/- 0 and 0.1 +/- 0 ng/ml (pre-operation) to 66.4 +/- 4.5 and 60.3 +/- 17.9 ng/ml at 8 h in blood and ascites, respectively; NO increased from 2.4 +/- 1.0 and 4.2 +/- 1.1 microM (pre-operation) to 11.9 +/- 0.7 and 36.9 +/- 2.1 microM in blood and ascites at 24 h and 48 h in blood and ascites, respectively. Interestingly, L-NMMA treatment significantly reduced the increased levels of TNF-alpha and CINC/GRO and altered the enhanced neutrophil functions (p < 0.05). CONCLUSION: These observations indicate that abdominal surgical trauma induces the production of NO, TNF-alpha and CINC/GRO, and enhances neutrophil functions such as chemotaxis, phagocytosis and active oxygen production. Furthermore, L-NMMA likely modulates the neutrophil functions and the production of TNF-alpha and CINC/GRO after the surgical trauma.

Abdomen↗
PubMed2001

Definitive surgical trauma care live porcine session: a technique for training in trauma surgery.

BACKGROUND: A new Definitive Surgical Trauma Care course was developed to educate surgeons in operative management of injuries. The course consists of an interactive CD-ROM and a live porcine animal laboratory. METHOD: A five-hour session was conducted. Penetrating injuries to stomach, bowel, diaphragm, spleen, pancreas, kidney, ureter, inferior vena cava, liver, and heart were created by the senior surgeon and managed by the junior surgeon. Participants rated their expertise in 26 maneuvers pre- and post-lab. The evaluation scale used was: no prior experience; able to perform skill with assistance; proficient at procedure; able to teach procedure to another surgeon. RESULTS: In 26 procedures, a maximum score of 78 was possible. There was an increase from pre- to post-session scores of 22.6 for PGY-4 residents (n = 3); 23.3 for PGY-5 residents (n = 4); 11.25 for fellows (n = 4); and 0 for attendings (n = 4). CONCLUSION: The operative animal session had the greatest educational benefit among surgeons without formal training in trauma surgery. By exposing them to a range of trauma-induced surgical conditions, the DSTC course develops their operative repertoire and should increase their effectiveness in managing trauma patients.

Animals↗
PubMed1996

Skeletal muscle glutathione after surgical trauma.

OBJECTIVE: The authors investigate the effect of surgical trauma on skeletal muscle concentrations of glutathione in patients undergoing selective abdominal surgery. SUMMARY BACKGROUND DATA: The posttraumatic state is accompanied by characteristic changes in the pattern of free amino acids and a decline of protein synthesis in human skeletal muscle. Glutathione has multiple metabolic functions that are involved in cellular homeostasis. It is unknown how surgical trauma affects the glutathione metabolism of skeletal muscle in surgical patients. METHODS: Eight patients undergoing elective abdominal surgery were investigated. Percutaneous muscle biopsies and blood samples were taken before operation and at 6, 24, and 48 hours after operation. The concentrations of glutathione were determined in muscle tissue, plasma, and whole blood, as well as the concentrations of the related amino acids in muscle and plasma. RESULTS: In skeletal muscle, the levels of both reduced and total glutathione decreased by 40% (p<0.01) at 24 hours and remained low at 48 hours after operation compared with the preoperative values. The glutathione concentration in plasma was 20% lower after operation compared with the concentration before operation (p<0.05). There were no changes at the whole blood levels of glutathione. Tissue glutamate and glutamine decreased significantly after operation (p<0.001), whereas intracellular cysteine and glycine remained unchanged. CONCLUSIONS: Skeletal muscle glutathione deficiency occurs after surgical trauma. This may lead to an increase in the susceptibility to intracellular oxidative injury.

Adult↗
PubMed1975

The function of polymorphonuclear leukocytes after surgical trauma.

The effect of surgical trauma on human polymorphonuclear leukocytes (PMN) was studied by measuring the hexosemonophosphate shunt (HMS) activity and myeloperoxidase mediated iodination during phagocytosis. Patients submitted to elective general surgery showed normal iodination capacity and normal HMS activity in their PMN cells postoperatively. This implies that postoperative infectious complications are not caused or promoted by defective PMN cell function. Iodination was found significantly (p less than 0.05) impaired in phagocytosing PMN cells from burned patients whereas it was found normal in traumatic and septic conditions. No direct relation between extent of injury and degree of leukocyte impairment was found. HMS activity remained normal in burned patients suggesting that the impaired iodination might depend on a defective mobilization of lysosomal enzymes.

Adolescent↗
PubMed1989

The influence of surgical trauma on experimental metastasis.

Influence of surgical trauma on experimental metastasis in healing wounds is investigated using a transplantable murine mammary carcinoma cell line, TA3Ha. Intravenous injection of 10(5), 10(6), and 2 x 10(6) TA3Ha cells into syngeneic Strain A mice led to liver or kidney tumor development in none of the 96, ten, and ten mice tested, respectively. In contrast, injection of 10(5) cells into mice immediately after hepatic wedge resection performed using milliwatt carbon dioxide laser and electrocautery resulted in tumor formation at the site of trauma in 21/37 (57%) and 25/52 (48%) mice, (P less than 0.001) respectively. Similar results were obtained in mice subjected to partial nephrectomy using the laser (nine of 18) and electrocautery (eight of 13). These results clearly demonstrate that surgical trauma renders a nonprivileged organ susceptible to experimental metastasis formation, and that at least in this model both laser and electrocautery have similar effects. Tumor cell injection 1, 7, and 10 days posthepatic surgery resulted in 36%, 20%, and 0% tumor formation, respectively, indicating that the earlier events in wound healing support tumor implantation and/or growth better than those later on. Frequency of tumor formation at sites of trauma in the peritoneum induced by scalpel blade, laser, and electrocautery were 28%, 50% and 82%, respectively. Peritoneal tumors were seen in 33% of the nonsurgical mice. Skin incisions induced with the three above probes had little influence on experimental metastasis formation. Thus the influence of trauma on tumor formation is not uniform in every organ.

Animals↗
PubMed1998

[Variations in interleukin-2 and interleukin-6 due to surgical trauma in cancer patients].

Inflammatory response after surgical trauma, which is necessary for infection control and tissue repairing, can actually produce some cytokines suppressive of the antitumoral immunity response. In this study the authors evaluate pre- and post-operative IL-2 (antitumor response activator) and IL-6 (lymphocytic response inhibitor and tumor growth factor) levels in 26 cancer patients undergoing resective surgery. Analysis of the results showed a significative IL-6 increase and a tendency to IL-2 decrease in the post-operative period. It is thus confirmed, even on the basis of the cytokines, the meaningful immunosuppressive effect of the surgical trauma on neoplastic growth control.

Aged↗
PubMed1997

[Changes in the cytokine concentration (Il-6, Il-8, Il-1ra) and their cellular expression of membrane molecules (CD25, CD30, HLA-DR) after surgical trauma].

UNLABELLED: Elective surgical approaches and trauma cause changes in the production of different cytokines, an increased production of acute phase protein and changes in the expression of different cell surface markers. METHODS: In a prospective study we examined the C-reactive protein level, the production of the cytokines IL-6, IL-8 and IL-1 RA in 25 laparoscopic and 21 conventional cholecystectomies. In addition the cell surface markers CD25 and CD30 on different cell populations and HLA-DR on monocytes were measured. Statistical analysis was made by Student's-t-test and Mann-Whitney's rank sum test. RESULTS: The humoral markers showed a more distinct increase in patients operated on conventionally two and 24 hours after surgery, the differences between the two surgical approaches were significant (p < 0.01). The cell surface markers CD25 and CD30 showed the same reaction. The HLA-DR expression on monocytes was significantly lower in patients operated on conventionally. CONCLUSIONS: Elective surgical approaches cause changes in the immune system, which can be evaluated by the reaction of cytokines and cell surface markers. Laparoscopic cholecystectomies cause less activation of the immune system than conventional operations.

Acute-Phase Reaction↗
PubMed1992

Surgical trauma, Candida infection, and serum proteolytic activity.

Both surgical trauma and infection can disturb the proteinase to proteinase inhibitor balance in the circulation. We sought to assess the effect of Candida albicans infection (INFX) on postoperative mortality, to correlate mortality with total serum proteolytic activity (PA), and to assess the impact of exogenous proteinase inhibitors (PI) on this mortality. Mice underwent midline laparotomy (LAP) and immediate postoperative intravenous C. albicans infection. LAP + INFX shortened mean survival compared to INFX or LAP alone. Quantitative renal cultures confirmed that death in the LAP + INFX and INFX groups was due to Candida sepsis. PA was measured using an 125I-labeled protein assay, yielding micrograms of acid-soluble peptides/100 microliters of serum. In control, sham-operated, and LAP groups, PA averaged less than 9.0, and mortality was 0. In INFX and LAP + INFX groups, PA averaged greater than 14.5 and mortality was high. To determine if high PA was related to high mortality, LAP + INFX mice were treated immediately preoperatively with a single dose of PI (1 mg alpha 1-proteinase inhibitor, 1 mg antithrombin, and 1000 KIU aprotinin). Mean survival increased with PI treatment. In conclusion, the addition of Candida infection to surgical trauma hastened mean time to death. More rapid death correlated with elevated PA and may reflect systemic imbalance in the proteinase to proteinase inhibitor ratio in the circulation. PI improved survival, suggesting that proteinase inhibition may prove useful in the future in the treatment of fungal sepsis in surgical patients.

Animals↗
PubMed1980

The relationship between the blood and vein wall fibrinolytic activities in response to surgical trauma.

The fibrinolytic response to surgical trauma was studied longitudinally in 7 pigs by measuring the fibrinolytic activity in the blood and vein wall simultaneously. The results indicated a marked suppression in fibrinolytic activity in the blood which was closely correlated with the activity in the vein wall. This correlation lends support to the hypothesis that the venous endothelium is the source of spontaneous fibrinolytic activity in the blood.

Animals↗
PubMed1996

[The pathogenesis of surgical trauma and the characteristics of its course in planned surgical interventions in the maxillofacial area].

Examinations carried out on 76 patients have shown that systematic surgical interventions into the maxillofacial area produce deep changes in the tissue and serum systems of proteolysis and their inhibitors. Activation of proteolytic enzymes already on the stage of surgical trauma leads to the formation in the operative wound of the focus of endotoxicosis which depresses antitryptic activity of injured tissues and thus promotes the development of purulent complications. The study of the above indexes at the early stages of acute period may serve as a diagnostic test while estimating a severity of operative wound and allows to make prognosis of the development of purulent complications.

Edema↗
PubMed1996

[Immune response induced by surgical trauma].

The non-specific immune response induced by surgical trauma is getting much attention with the concept of systemic inflammatory response syndrome (SIRS). SIRS is recognized as the host response to an inflammatory process independent of its cause, and is characterized by generalized activation of the vascular endothelium and polymorphonuclear leukocyte. It is induced by cytokine production, in which tumor necrosis factor (TNF) and interleukin-1 (IL-1) play a major role. Most of SIRS patients recover from surgical trauma without developing organ dysfunction. However, a new subsequent insult (second attack), such as infection, during SIRS state would lead to amplified tissue response. SIRS should be managed as a warning sign of tissue injury.

Cytokines↗
PubMed1988

The pattern of leucocyte response to surgical trauma in the African Negro.

The leucocyte response to surgical trauma in the Nigerian Negro is investigated. The surgical operations were graded, according to the degree of anticipated tissue trauma, into minor, intermediate and major, in 66 patients (27 males and 39 females) who had elective surgical operations with no sign of infection. The peripheral blood total and differential leucocyte counts were determined pre-operatively and at 2 h, 24 h, and 7 days postoperatively. A highly significant increase (P less than 0.001) in the total leucocyte, polymorphonuclear leucocyte (PMN) and stab cell counts occurred 2 h and 24 h after major surgery. These changes persisted for 7 days after major surgery except for the stab cell count which was by then no longer significantly raised. Similarly, highly significant increases occurred in the total and PMN counts 2 h and 24 h after intermediate surgery. The increases were not significant by the 7th postoperative day. There was a decrease in the lymphocyte counts after major surgery which was not significant at 2 h but was just significant (P less than 0.05) 24 h postoperatively. There was a return to the pre-operative level by the 7th postoperative day. There were no significant changes in the leucocyte counts after minor surgery or in the monocyte, eosinophil and basophil counts after intermediate or major surgery. Despite lower pre-operative total leucocyte (WBC) and PMN counts found in this study, the total leucocyte and PMN response to surgical trauma in the Nigerian Negro is similar to previous observations made in the Caucasian. The response of lymphocytes in the Nigerian Negro, however, differs from that reported in the Caucasian and demands further study.

Adolescent↗