11.  Does the use of epinephrine in xylocaine potentiate infection?  (PRS 1985; 76:933)

Answer:
bacterial contamination in wound +  saline  =  no organisms seen
bacteria + 1:100,000 epinephrine = grossly infected
bacteria + 1:200,000 epinephrine = 1 x 106 organisms
bacteria + 1:400,000 epinephrine = 0.02 x 106 organisms

Suspected mechanism:
1) Epinephrine produces tissue hypoxia that is dose related. Hypoxia retards killing of Staphylococcus by leukocytes.
2) Tissue blood flow is reduced by epinephrine and it is conceivable that the number of leukocytes present in these wounds was decreased.

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