Sustained impairments in cutaneous vasodilation and sweating in grafted skin following long-term recovery.
We previously identified impaired cutaneous vasodilation and sweating in grafted skin 5 to 9 months postsurgery. The aim of this investigation was to test the hypothesis that cutaneous vasodilation, but not sweating, is restored as the graft heals. Skin blood flow and sweat rate were assessed from grafted skin and adjacent noninjured skin in three groups of subjects: 5 to 9 months postsurgery (n=13), 2 to 3 years postsurgery (n=13), and 4 to 8 years postsurgery (n=13) during three separate protocols: 1) whole-body heating and cooling, 2) local administration of vasoactive drugs, and 3) local heating and cooling. Cutaneous vasodilation and sweating during whole-body heating were significantly lower (P<.001) in grafted skin when compared with noninjured skin across all groups and demonstrated no improvements with recovery time postsurgery. Maximal endothelial-dependent (acetylcholine) and endothelial-independent (sodium nitroprusside) cutaneous vasodilation remained attenuated (P<.001) in grafted skin up to 4 to 8 years postsurgery, indicating postsynaptic impairments. In grafted skin, cutaneous vasoconstriction during whole-body and local cooling was preserved, whereas vasodilation to local heating was impaired, regardless of the duration postsurgery. Split-thickness skin grafts have impaired cutaneous vasodilation and sweating up to 4 to 8 years postsurgery, thereby limiting the capability of this skin's contribution to thermoregulation during a heats stress. In contrast, grafted skin has preserved vasoconstrictor capacity.
Davis
Scott L
SL
Institute for Exercise and Environmental Medicine, Presbyterian Hospital of Dallas, and Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas 75231, USA.
Shibasaki
Manabu
M
Low
David A
DA
Cui
Jian
J
Keller
David M
DM
Wingo
Jonathan E
JE
Purdue
Gary F
GF
Hunt
John L
JL
Arnoldo
Brett D
BD
Kowalske
Karen J
KJ
Crandall
Craig G
CG
D000109:Acetylcholine / Q000008:administration & dosage; D000328:Adult; D001831:Body Temperature; D001833:Body Temperature Regulation; D002056:Burns / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D017551:Microdialysis; D009599:Nitroprusside / Q000008:administration & dosage; D012867:Skin / Q000098:blood supply*; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply*; D013546:Sweating / Q000502:physiology; D014182:Transplantation, Autologous; D014664:Vasodilation / Q000502:physiology
D009599:Nitroprusside; D000109:Acetylcholine