Lucas Valentina Sage, McCain Nancy, Elswick R K, Pozez Andrea L
Valentina Sage Lucas, PhD, RN, ANP-BC, is at Virginia Commonwealth University, Richmond; and Virginia Commonwealth University Health System, Richmond. Nancy McCain, DSN, RN, FAAN, is at Virginia Commonwealth University, Richmond. R. K. Elswick, PhD, is at Virginia Commonwealth University, Richmond. Andrea L. Pozez, MD, FACS, is at Virginia Commonwealth University, Richmond; Virginia Commonwealth University Health System, Richmond.
Plast Surg Nurs. 2018 Apr/Jun;38(2):55-72. doi: 10.1097/PSN.0000000000000223.
This was a pilot study to examine pre- and postoperative stress experienced by women who were undergoing autologous breast reconstruction and how stress might impact wound healing, specifically examining cytokines and other chemical mediators in the wound environment. A nonexperimental descriptive design over time was utilized. Participants were women who were undergoing autologous abdominal breast reconstruction for breast cancer (N = 20). Data were collected preoperatively and at 24, 48, 72, and 96 hr postsurgery. Complications were monitored intraoperatively and up to 30 days postsurgery. Psychological stress was measured with the 10-item Perceived Stress Scale (PSS), the Impact of Events Scale-Revised (IES-R), and a 100-mm Visual Analog Scale (VAS). Cytokines were assayed using the 27-plex kit with a Bio-Plex Plus. Although breast cancer is considered a stressor, in this sample of women, scores of the PSS, IES-R, and VAS showed that in fact these participants experienced low levels of psychological stress. All measured biochemical mediators in serum and wound fluid were detected and trends were identified. IL-1ra, IL-6, IL-8, G-CSF, IP-10, MCP-1, MIP-1β, RANTES, and VEGF were present in the highest concentrations. Significant changes in levels of cytokines in wound fluid were observed in IL-1β, IL-2, IL-5, IL-6, IL-8, IL-9, IL-10, IL-17, FGF-basic, G-CSF, MIP-1α, PDGF-bb, MIP-1β, RANTES, and TNF-α. The remaining cytokine concentrations stayed stable over time. These findings suggest that although these women were not experiencing high levels of stress, meaningful cytokine patterns were detected.
这是一项试点研究，旨在调查接受自体乳房重建的女性术前和术后所经历的压力，以及压力如何影响伤口愈合，具体而言是研究伤口环境中的细胞因子和其他化学介质。采用了随时间变化的非实验性描述性设计。参与者为因乳腺癌接受自体腹部乳房重建的女性（N = 20）。在术前以及术后24、48、72和96小时收集数据。术中及术后30天监测并发症情况。使用10项感知压力量表（PSS）、事件影响量表修订版（IES-R）和100毫米视觉模拟量表（VAS）测量心理压力。使用带有Bio-Plex Plus的27种细胞因子检测试剂盒测定细胞因子。尽管乳腺癌被视为一种应激源，但在这个女性样本中，PSS、IES-R和VAS的得分表明，实际上这些参与者经历的心理压力水平较低。检测了血清和伤口液中所有测量的生化介质并确定了趋势。IL-1ra、IL-6、IL-8、G-CSF、IP-10、MCP-1、MIP-1β、RANTES和VEGF的浓度最高。在伤口液中观察到IL-1β、IL-2、IL-5、IL-6、IL-8、IL-9、IL-10、IL-17、碱性成纤维细胞生长因子、G-CSF、MIP-1α、血小板衍生生长因子bb、MIP-1β、RANTES和肿瘤坏死因子-α等细胞因子水平有显著变化。其余细胞因子浓度随时间保持稳定。这些发现表明，尽管这些女性没有经历高水平的压力，但仍检测到了有意义的细胞因子模式。
