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Lumbar sympathectomy accelerates sacrococcygeal wound healing in rats

Zhifang Zheng, Yishu Liu, Xuan Min, Jianbing Tang, Biao Cheng

Pressure Ulcers (PUs) severely impair patient quality of life and account for a high percentage of annual healthcare costs. Lumbar sympathectomy has previously been used for the treatment of chronic leg ulcers. It is still unclear, however, whether lumbar sympathectomy accelerates wound healing in sacrococcygeal skin, a high-risk area for PUs in mostly bedridden patients. Thirty-six Sprague Dawley rats were randomly assigned to the lumbar sympathectomised group, the sham-operated group, and the blank control group. Two wounds were generated in the sacrococcygeal skin of each rat 2 w after modelling. The expression of dopamine β-hydroxylase (DβH) and Norepinephrine (NE) in sacrococcygeal skin were detected by immunohistochemistry and western blotting. The wounds were photographed and measured with Image-Pro Plus v 6.0 software. Then, the wounds were cut and observed by haematoxylin and eosin staining for re-epithelialization and Masson’s Trichrome staining for collagen fibres on d 3, 7, and 21 post-wounding. DβH and NE expression in sacrococcygeal skin were reduced 2 w after sympathectomy. Lumbar sympathectomy accelerated sacrococcygeal wound contraction (p<0.05). There were no statistical differences among groups in the scores of reepithelialisation. The integrated optical densities of stained collagen were increased after sympathectomy in sacrococcygeal wounds (p ≤ 0.001). In conclusion, lumbar sympathectomy accelerates sacrococcygeal wound healing in rats. Lumbar sympathectomy may be beneficial for the healing of PUs in the sacrococcygeal region.