Hui P S, Pu L L, Kucukceleki A, Ko F, Cowan W T, Phillips L G, Heggers J P, Robson M C
Division of Plastic Surgery, University of Texas Medical Branch, Galveston, USA.
Surgery. 1999 Nov;126(5):933-8. doi: 10.1016/s0039-6060(99)70035-8.
The present study was undertaken to investigate the effect of denervation on leukocyte function in soft-tissue infection in an isolated in vivo ovine flap model.
Fifteen adult ewes were divided into three groups. An island pedicle flap was raised on the right buttock. In group I (no denervation), the cutaneous nerve remained intact, whereas in group II (acute denervation) the nerve was divided acutely. In group III (prolonged denervation) the nerve was divided 7 days before flap elevation. All flaps received intradermal inoculation of 10(7) Staphylococcus aureus, and the animals were observed for 96 hours.
In both groups II and III, the leukocyte chemiluminescence and chemotaxis were significantly decreased when compared with group I. Furthermore, there was profound impairment of leukocyte functions in group III compared with group II. Group III also had significantly higher bacterial counts, larger septic foci, lower viable leukocyte ratios, and decreased bacterial killing compared with group I.
Denervation, particularly over a period of time, results in increased bacterial growth of soft-tissue septic foci. This appears to be due to decreased leukocyte function resulting in diminished bacterial killing.
本研究旨在通过一个离体的活体绵羊皮瓣模型,探讨去神经支配对软组织感染中白细胞功能的影响。
将15只成年母羊分为三组。在右侧臀部掀起一个岛状蒂皮瓣。第一组(未去神经支配组),皮神经保持完整;而第二组(急性去神经支配组),神经被急性切断。第三组(长期去神经支配组)在皮瓣掀起前7天切断神经。所有皮瓣均皮内接种10⁷金黄色葡萄球菌,对动物观察96小时。
与第一组相比,第二组和第三组的白细胞化学发光和趋化性均显著降低。此外,与第二组相比,第三组白细胞功能有严重损害。与第一组相比,第三组的细菌计数也显著更高,脓灶更大,存活白细胞比例更低,细菌杀灭能力下降。
去神经支配,尤其是经过一段时间后,会导致软组织脓灶细菌生长增加。这似乎是由于白细胞功能下降导致细菌杀灭能力减弱所致。