April 1992

Mesenteric Lymphadenectomy Prevents Postburn Systemic Spread of Translocated Bacteria

Author Affiliations

From the the Shriners Burns Institute (Drs Tokyay, Zeigler, Loick, Heggers, De la Garza, Traber, and Herndon), and University of Texas Medical Branch (Drs Zeigler, Heggers, Traber, and Herndon), Galveston.

Arch Surg. 1992;127(4):384-388. doi:10.1001/archsurg.1992.01420040026003

• We investigated the role of mesenteric lymph nodes in postburn systemic spread of intestinal bacteria. Group 1 minipigs (n = 8) had a 40% third-degree burn. Group 2 minipigs (n = 7) had the same burn injury, but their mesenteric lymph nodes were removed immediately after burn. Group 3 minipigs (n = 8) had sham burn, and group 4 minipigs (n = 6) had mesenteric lymph node removal under anesthesia. All minipigs were killed at 48 hours, and tissues were harvested for bacteriological culture. Group 1 showed a large number of positive cultures from several of the systemic organs. Group 2 demonstrated no positive cultures in any of the tissues except the peritoneal fluid. These data suggest that bacterial translocation occurs mainly via mesenteric lymphatics to mesenteric lymph nodes and, thence, into other systemic tissue. After major burns, mesenteric lymph nodes may become an additional focus of infection.

(Arch Surg. 1992;127:384-388)