Complement activation and release of interleukin-6 and tumour necrosis factor-α in drained and systemic blood after major orthopaedic surgery

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Abstract
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 α (TNF‐α) in systemic and drained wound blood for the first six hours after a major orthopaedic operation. Design: Prospective study. Setting: University hospital, Norway. Patients: 8 patients operated on for thoracic scoliosis. Main outcome measure: Concentrations of complement activation products, IL‐6 and TNF‐α 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‐α 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. Conclusion: 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. Copyright © 1998 Taylor and Francis Ltd.

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