Higashimori Haruki, Carlsen Richard C, Whetzel Thomas P
Division of Plastic and Reconstructive Surgery, Department of Physiology & Membrane Biology, School of Medicine, University of California at Davis, Sacramento, California 95817, USA.
Plast Reconstr Surg. 2006 Jan;117(1):152-64. doi: 10.1097/01.prs.0000186537.62939.07.
A full-thickness 20 percent body surface area burn in mice produces a significant decrease in tibial motor nerve conduction velocity within 6 hours of the burn and in sensory conduction velocity within 7 days. This suggests that cutaneous burn injury produces a systemic response that affects peripheral motor and sensory nerve function at a distance from the burn site. The authors tested the hypothesis that burn wound excision either 30 minutes or 3 hours after burn would prevent neuropathy.
A 20 percent body surface area third-degree burn was applied to the backs of anesthetized mice using procedures that followed National Institutes of Health guidelines. Motor nerve conduction velocity and sensory conduction velocity were determined in intact, anesthetized mice by percutaneous nerve stimulation. Burn wounds were excised and closed at 30 minutes or 3 hours after burn. Motor nerve conduction velocity and sensory conduction velocity were measured before burn and 1, 3, 7, 14, and 21 days after a burn or sham procedure. The number of circulating neutrophils and serum concentrations of tumor necrosis factor-alpha, nitrite, and electrolytes were also determined in each group.
Motor nerve conduction velocity and sensory conduction velocity in the 30-minute excision (n = 10) and sham group (n = 5) were not significantly different. Motor nerve conduction velocity and sensory conduction velocity in the nonexcised group (n = 10) and 3-hour excision group (n = 10) were significantly decreased. Serum tumor necrosis factor-alpha concentration was elevated 6 hours after burn in nonexcised animals (n = 9) and in 3-hour excision mice (n = 8) but was not significantly different in the sham (n = 8) and the 30-minute excision group (n = 7).
The authors conclude that burn wound excision at 30 minutes but not at 3 hours prevents the nerve conduction deficits measured in mice with 20 percent body surface area burns. The cellular basis of burn-induced neuropathy is unknown, but nitric oxide and tumor necrosis factor alpha-alpha appear to play a role.
小鼠体表20%体表面积的全层烧伤会导致烧伤后6小时内胫神经运动神经传导速度显著下降,7天内感觉神经传导速度显著下降。这表明皮肤烧伤损伤会引发一种全身反应,影响远离烧伤部位的外周运动和感觉神经功能。作者检验了烧伤后30分钟或3小时进行烧伤创面切除可预防神经病变的假设。
按照美国国立卫生研究院的指南,对麻醉的小鼠背部进行20%体表面积的三度烧伤。通过经皮神经刺激在完整的麻醉小鼠中测定运动神经传导速度和感觉神经传导速度。在烧伤后30分钟或3小时切除并闭合烧伤创面。在烧伤或假手术前以及烧伤后1、3、7、14和21天测量运动神经传导速度和感觉神经传导速度。还测定了每组循环中性粒细胞的数量以及肿瘤坏死因子-α、亚硝酸盐和电解质的血清浓度。
30分钟切除组(n = 10)和假手术组(n = 5)的运动神经传导速度和感觉神经传导速度无显著差异。未切除组(n = 10)和3小时切除组(n = 10)的运动神经传导速度和感觉神经传导速度显著降低。未切除动物(n = 9)和3小时切除小鼠(n = 8)在烧伤后6小时血清肿瘤坏死因子-α浓度升高,但在假手术组(n = 8)和30分钟切除组(n = 7)中无显著差异。
作者得出结论,烧伤后30分钟而非3小时进行烧伤创面切除可预防20%体表面积烧伤小鼠中测得的神经传导缺陷。烧伤诱导神经病变的细胞基础尚不清楚,但一氧化氮和肿瘤坏死因子-α似乎起作用。