<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Microvascular free flap surgery is a complex method of wound closure for large wounds. Tissue trauma, surgical stress and general anaesthesia are known immunosuppressors that may exacerbate postoperative infections. Beta-herpesviruses HHV-6 and HHV-7 are immunomodulating viruses highly prevalent in the population of healthy individuals, which can interfere with the function of the host immune system. These viruses can be reactivated in immunosuppressed conditions. The aim of this study was to monitor the potential effects of two different anaesthesia techniques - general anaesthesia (GA) and regional anaesthesia (RA) - on the activation of HHV-6 and HHV-7 infection in relation to changes in the total lymphocyte count and peripheral immune cell distribution after microvascular free flap surgery. We found significant increase in the frequency of active HHV-7 infection after surgery (p &lt; 0.05) in the GA group. In the RA group changes were not significant. The activation of HHV-7 infection was associated with decrease in the total lymphocyte count post-operatively in patients from the GA group. The data of our study show that reconstructive flap surgery under GA is linked with more frequent postoperative lymphopenia, which is a potential post-operative immunosuppressor that probably triggers the activation of HHV-6 and HHV-7 infection</p></abstract>

Microvascular free flap surgery is a complex method of wound closure for large wounds. Tissue trauma, surgical stress and general anaesthesia are known immunosuppressors that may exacerbate postoperative infections. Beta-herpesviruses HHV-6 and HHV-7 are immunomodulating viruses highly prevalent in the population of healthy individuals, which can interfere with the function of the host immune system. These viruses can be reactivated in immunosuppressed conditions. The aim of this study was to monitor the potential effects of two different anaesthesia techniques - general anaesthesia (GA) and regional anaesthesia (RA) - on the activation of HHV-6 and HHV-7 infection in relation to changes in the total lymphocyte count and peripheral immune cell distribution after microvascular free flap surgery. We found significant increase in the frequency of active HHV-7 infection after surgery (p < 0.05) in the GA group. In the RA group changes were not significant. The activation of HHV-7 infection was associated with decrease in the total lymphocyte count post-operatively in patients from the GA group. The data of our study show that reconstructive flap surgery under GA is linked with more frequent postoperative lymphopenia, which is a potential post-operative immunosuppressor that probably triggers the activation of HHV-6 and HHV-7 infection

Potential Effect of Two Different Anaesthesia Techniques on the Activation of Hhv-6 and Hhv-7 Infection in Relation to Changes in Total Lymphocyte Count and Peripheral Immune Cell Distribution after Prolonged Microvascular Free Flap Surgery / Divu Atšķirîgu Anestēzijas Metožu Ietekme Uz Hhv-6 Un Hhv-7 Infekcijas Aktivāciju Saistībā Ar Limfocītu Skaitu Izmaiņām Un Perifēro Imūno Šūnu Sadali Pēc Ilgstošām Mikrovaskulārām Brīvo Lēveru Operācijām

Division of Doctoral Studies, Rîga Stradiņš University, Dzirciema iela 16, Rîga, LV-1007, LATVIA

A. Kirhenšteins Institute of Microbiology and Virology, Rîga Stradiņš University, Râtsupîtes iela 5, Rîga, LV-1069, LATVIA

Rîga Eastern Clinical University Hospital, Latvian Oncology Centre, Hipokrâta iela 4, Rîga, LV-1039, LATVIA

Rîga East Clinical University Hospital Gaiïezers, Hipokrâta iela 2, Rîga, LV-1039, LATVIA

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Microvascular free flap surgery is a complex method of wound closure for large wounds. Tissue trauma, surgical stress and general anaesthesia are known...

Published Online: Dec 30, 2014

Page range: 216 - 221

Received: Aug 23, 2014

DOI: https://doi.org/10.2478/prolas-2014-0026

© by Arnis Vilks

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.