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Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds
Authors:Brendan Carvalho  David J Clark  David Yeomans  Martin S Angst
Institution:Department of Anesthesia, Stanford University School of Medicine
Abstract:We describe a methodology by which we are able to collect and measure biochemical inflammatory and nociceptive mediators at the surgical wound site. Collecting site-specific biochemical markers is important to understand the relationship between levels in serum and surgical wound, determine any associations between mediator release, pain, analgesic use and other outcomes of interest, and evaluate the effect of systemic and peripheral drug administration on surgical wound biochemistry. This methodology has been applied to healthy women undergoing elective cesarean delivery with spinal anesthesia. We have measured wound exudate and serum mediators at the same time intervals as patient''s pain scores and analgesics consumption for up to 48 hours post-cesarean delivery. Using this methodology we have been able to detect various biochemical mediators including nerve growth factor (NGF), prostaglandin E2 (PG-E2) substance P, IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, TNFα, INFγ, G-CSF, GM-CSF, MCP-1 and MIP-1β. Studies applying this human surgical wound bioassay have found no correlations between wound and serum cytokine concentrations or their time-release profile (J Pain. 2008; 9(7):650-7).1 We also documented the utility of the technique to identify drug-mediated changes in wound cytokine content (Anesth Analg 2010; 111:1452-9).2
Keywords:Medicine  Issue 68  Biochemistry  Anatomy  Physiology  Cytokines  Cesarean Section  Wound Healing  Wounds and Injuries  Surgical Procedures  Operative  Surgical wound  Exudate  cytokines  Substance P  Interleukin 10  Interleukin 6  Nerve growth factor  Prostaglandin E2  Cesarean  Analgesia
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