| Objective: To investigate the feasibility of escharectomy en mass at 6PBH(post burn hour) and it's effect on the levels of circulation cytokines in minipigs with 35% TBSA(total body surface aera) Ⅲ degree scald.Methods: Healthy Chinese experimental minipigs (number=14,body weight 18±2Kg) randomly divided into two groups:experimental group (E,=7);control group (C,n=7).Feed the animals for adaptablity one week before scald ,nothing was given them to drink or to eat for 12 hours before experiment .Thiothal sodium (25-30mg/Kg) was given through intraperitoneal injection then made it in ventral decubitus when it was perfectly anesthetized .The long hair on it's back and limbs was scissorsed and the solution of 10% sodium sulfide was used to epilate . Swan-Ganz catheter was put into right atrial through the external jugular vein for the use of monitoring the hemodynamics indexes and guidance the fluid infusion .Polythene catheter was put into the arteria carotis externa for the use of drawing blood .Determine the hemodynamics indexes (CO cardiac output RAP right atrial pressure) before scald . In the same time drawing blood to detect hemerheology indexes .Blood sample wascentrifugated at once . Serum drawing out was preserved at the temperature of -70℃ with the aim of cytokines detection . According to the formula S=K?W0.4 ?L0.6(K=17.5 W= body weight Kg L=height cm) Calculate the aera of 35% TBSA then delimit this area to be scalded on it's back . With the other area protected properly the animal's back was put into hot water (80℃) for one minute and which made Ⅲ degree scald (confirmed by the pathology slice) . Animals of two groups were given fluid infusion in one hour . Crystal fluid and colloid fluid were given in alternation . Animals took food freely after 48PBH . The E,C group were given escharectomy en mass respectively at 6PBH and 24PBH . All animals were cut blade thickness skin by dermatome from limbs where had been epilated .The skin grafts were transplanted on the wounds . Swan-Ganz catheter and artery catheter together with the electrocardioscope transducer were made linked together then record the number of CO and RAP on each time .Blood was drew out to detect the viscosity of whole blood and the erythrocytic aggulation index by the full-automatic hemerheology instrument (CSL-50 type) . Indexes above-mentioned were detected at the time of normal ,6PBH ,8PBH,16PBH,24PBH,48PBH and 72PBH . Blood was drew out at the time aforeside and 1PBW (post burn week) .Samples were centrifugated (3000r/min ,10 min) prompt . Serum was preserved at the temperature of -70℃ . The methods of determineinterleukin-1β (IL-1β),interleukin-8 (IL-8),interleukin-10 (IL-10) and tumor necrosis factor-α (TNF-α) were ELISA (enzyme linked immunosorbent assay) .The kits were offered by the Biosource company .the experimental data were handaled by the software of SPSS . Result:1.The changes of hemodynamics : The CO and RAP of E group began to rise again at 8PBH and they came to the normal level at 48PBH then keep relative steady after this time . The CO of C group keep continued dropping . It had been 58% of normal value at 8PBH and 41% at 24PBH . It rised dramatically after escharectomy and came to normal level at 48PBH , then it still keep rising . The RAP of C group came to the lowest trough at 8PBH then rise up slowly following fluid infusion . It came to normal value at 72PBH .To sum up all its changes :E group fluctuated a smaller range and regain more quickly when compared with C group . So a more steady condition was made for the organism in E group around the operation . 2.The changes of hemerheology : The statistical data indicated that there wasn't notable difference between the two groups . 3.There was similarity changes between TNF-α and IL-10:Both indexes of two groups presented two-humped change . There was a low wave crest after a high one in E group .It was contrary in C group .The indexes in E group came to the normal level at 1PBW whereas indexes in C group was much... |
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