Related Experiment Videos
The suppressive effect of subeschar tissue fluid upon in vitro cell-mediated immunologic function
J J Ferrara1, D L Dyess, A Luterman
1Department of Surgery, University of South Alabama, Mobile 36688.
The Journal of Burn Care & Rehabilitation
|November 1, 1988
Summary
Subeschar tissue fluid (STF) beneath burn wounds acts as an immunosuppressive reservoir, potentially hindering microbial clearance. Surgical removal of this fluid during fascial excision may improve patient outcomes by reducing immunosuppression.
Area of Science:
- Immunology
- Burn Care
- Wound Healing
Background:
- Fluid resuscitation in burn patients can lead to fluid accumulation in the subeschar space, traditionally considered inert.
- The immunobiologic role of this subeschar tissue fluid (STF) has not been fully elucidated.
Purpose of the Study:
- To investigate whether subeschar tissue fluid (STF) functions as an immunobiologic reservoir in burn patients.
Main Methods:
- Seven burn patients (mean BSA burn 55%) underwent fluid resuscitation and topical burn treatment.
- Subeschar tissue fluid (STF) was collected during fascial excision.
- Chemical analysis and bacterial cultures of STF were performed.
- Immunosuppressive capacity of STF was assessed by its effect on mitogen-induced lymphocyte blastogenesis.
Main Results:
- Chemical analysis of STF revealed similarities to serum; no bacterial organisms were cultured.
- Dilutions of STF and burn serum significantly suppressed lymphocyte blastogenesis compared to control serum.
- STF demonstrated significantly greater immunosuppressive activity than burn serum (P < .03).
Conclusions:
- STF may function as an immunologic barrier, impeding microbial clearance in viable subcutaneous tissue.
- STF may serve as a reservoir for systemically absorbed immunosuppressive factors.
- Fascial excision, beyond debridement, may offer therapeutic benefits by removing immunosuppressive STF.