PRODUCTION OF INTERLEUKIN-6 AT OPERATIVE WOUND SITES IN SURGICAL PATIENTS

BACKGROUND: Interleukin-6 (IL-6) plays a central role in the acute pha se of inflammation after surgical injury. The serum concentration of I L-6 increases during an operation. The mechanisms of this increase in the serum IL-6 level, however, has not yet been fully clarified. STUDY DESIGN: To determine the possibility of production of IL-6 at the ope rative wound site and its regulation by humoral factors in surgical pa tients, the IL-6 secretion of biopsied skin obtained from an operative wound both before and after the operation were quantitated by using o rgan culture techniques. RESULTS: When skin explants obtained from the uninjured skin were cultivated and the amounts of IL-6 secreted into the culture medium were measured, IL-6 secretion increased exponential ly during culture, which indicated that the stress of the skin incisio n induced IL-6 production. The skin specimens obtained from the operat ive wounds postoperatively secreted a significantly larger amount of I L-6 than those obtained from uninjured skin either preoperatively or p ostoperatively, implying that skin at the site of the operative wound had been more sensitized to produce IL-6 because of the surgical injur y. The IL-6 secretion by skin explants was significantly enhanced eith er by tumor necrosis factor or interleukin-1, while it was inhibited b y corticosteroids. CONCLUSIONS: Interleukin-6 production at the site o f the operative wound is partly responsible for the elevation of the s erum IL-6 level during the operation. Organ cultures of the skin expla nts may provide a feasible system for research on the cytokine network s in surgical patients.