Complement activation and release of interleukin-6 and tumour necrosis factor-alpha in drained and systemic blood after major orthopaedic surgery.
OBJECTIVE
To measure the concentration of complement activation products C3bc and terminal complement complex (TCC) and the cytokines interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-alpha) in systemic and drained wound blood for the first six hours after a major orthopaedic operation.


METHODS
Prospective study.


METHODS
University hospital, Norway.


METHODS
8 patients operated on for thoracic scoliosis.


METHODS
Concentrations of complement activation products, IL-6 and TNF-alpha in arterial (systemic) and drained (local) blood were measured at wound closure and 1, 2, 4, and 6 hours postoperatively.


RESULTS
C3bc and TCC were 10 times higher, and IL-6 showed extreme values, in drained compared with arterial blood. The concentration of TNF-alpha did not increase significantly, either in drained or in arterial blood. The white cell count (WCC) increased threefold in both drained and arterial blood compared with arterial control values before operation.


CONCLUSIONS
Complement activation and IL-6 release after surgical trauma differ significantly in local and systemic blood samples. Conclusions based only on systemic findings may be limited.
Krohn
C D
CD
Center for Orthopaedics, National Hospital, University of Oslo, Norway.
Reikerås
O
O
Mollnes
T E
TE
Aasen
A O
AO
D000293:Adolescent; D000328:Adult; D003167:Complement Activation; D003179:Complement C3b / Q000032:analysis; D015938:Complement Membrane Attack Complex / Q000032:analysis; D004322:Drainage; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D009985:Orthopedics; D011446:Prospective Studies; D012600:Scoliosis / Q000601:surgery; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis*
D015938:Complement Membrane Attack Complex; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D003179:Complement C3b