Bridges M, Morris D, Hall J R, Deitch E A
J Surg Res. 1987 Aug;43(2):133-8. doi: 10.1016/0022-4804(87)90155-7.
Although local failure of antibacterial host defenses in the surgical wound may contribute to the development of wound infections, little attention has been focused on this problem. The goals of the current study were to determine the biological activity of postsurgical wound exudates (seroma fluids) on normal neutrophil and lymphocyte function and to quantitate the levels of complement and plasma fibronectin in these wound exudates. The wound exudates did not support the opsonophagocytosis and killing of Staphylococcus aureus or Pseudomonas aeruginosa by control neutrophils as well as serum (P less than 0.01) and was inferior to serum as a neutrophil chemoattractant (P less than 0.01). Similarly, the wound exudates did not support mitogen-induced lymphocyte blastogenesis as well as normal serum (P less than 0.01). The impaired function of both neutrophils and lymphocytes incubated in the wound exudates appeared to be due to a lack of normal humoral factors, rather than to the presence of inhibitory factors, since the addition of normal serum to the wound exudates restored cellular activity to normal. The findings of decreased levels of plasma fibronectin and decreased complement hemolytic activity in the wound exudates were consistent with the concept of a local deficiency of immune-related humoral factors. Thus, this study supports the clinical concept that local collections of wound fluids may predispose to wound infections by hampering effective local host defenses.
尽管手术伤口处抗菌宿主防御的局部失效可能导致伤口感染的发生，但这一问题很少受到关注。本研究的目的是确定术后伤口渗出液（血清肿液）对正常中性粒细胞和淋巴细胞功能的生物学活性，并定量这些伤口渗出液中补体和血浆纤维连接蛋白的水平。伤口渗出液不能像血清一样支持对照中性粒细胞对金黄色葡萄球菌或铜绿假单胞菌的调理吞噬作用和杀伤作用（P<0.01），并且作为中性粒细胞趋化剂不如血清（P<0.01）。同样，伤口渗出液不能像正常血清一样支持有丝分裂原诱导的淋巴细胞增殖（P<0.01）。在伤口渗出液中孵育的中性粒细胞和淋巴细胞功能受损似乎是由于缺乏正常的体液因子，而不是由于存在抑制因子，因为向伤口渗出液中添加正常血清可使细胞活性恢复正常。伤口渗出液中血浆纤维连接蛋白水平降低和补体溶血活性降低的结果与免疫相关体液因子局部缺乏的概念一致。因此，本研究支持了临床观点，即伤口液体的局部积聚可能通过阻碍有效的局部宿主防御而导致伤口感染。
