In Vivo Neutrophil Delivery to Inflammatory Sites in Surgical Patients

We examined the interrelationships between leukocyte adherence (ADH), polymorphonuclear neutrophil (PMN) chemotaxis (CTX), and PMN delivery to an inflammatory focus in hospitalized patients. Patients included 25 men and 17 women, with a mean age of 62.8 years, who were admitted for major elective surgery. The patients were studied preoperatively and on the second and seventh postoperative days. Leukocyte adherence increased on the second postoperative day (82.3%, P less than .05) and remained elevated on the seventh postoperative day (81.6%). Polymorphonuclear neutrophil chemotaxis decreased significantly on the second postoperative day (3.4 to 2.9 cm, P less than .05), but returned to normal by the seventh postoperative day. The PMN delivery to skin-window chambers decreased markedly on the second postoperative day (1.28 million cells, P less than .05) with a further decrease on the seventh postoperative day (0.82 million cells). There was no correlation between in vitro PMN CTX and in vivo cell delivery. We conclude that major surgery leads to increased ADH, decreased PMN CTX, and diminished PMN delivery to areas of inflammation. However, a single measure of PMN function such as in vitro PMN CTX does not, alone, reflect in vivo PMN delivery to areas of inflammation.