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Connective tissue response to major surgery and postoperative infection
Author(s) -
HAUKIPURO K.,
MELKKO J.,
RISTELI L.,
KAIRALUOMA M. I.,
RISTELI J.
Publication year - 1992
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/j.1365-2362.1992.tb01471.x
Subject(s) - protein precursor , procollagen peptidase , medicine , connective tissue , wound healing , gastroenterology , surgery , endocrinology , pathology , chemistry , biochemistry , gene
. Type I and type III collagen are components of a healing wound, and major structural proteins. According to our previous study, wound fluid concentrations of the liberated propeptide extensions of procollagens can be used to monitor collagen synthesis in the wound. Serum concentrations of the carboxy‐terminal propeptide of type I procollagen (PICP), and the aminoterminal propeptide of type III procollagen (PIIINP) were studied here for up to half a year in 102 patients, admitted for major abdominal surgery. In a frequent follow‐up ( n = 9), one minimum and two maxima were found for S‐PICP, occurring 1 day, 7 days, and 2 months after surgery, respectively. S‐PIIINP had a minimum at 1 day and a peak at 10 days. Relative changes (follow‐up result/pre‐operative concentration) of the propeptides in 50 uncomplicated patients were compared. The 1‐day minimum of S‐PICP was 0.60 (SD 0.18), and that of S‐PIIINP 0.89 (0.27), ( P <0.0001, 95% CI for the mean difference 0.21 to 0.36). The 7‐day peak of S‐PICP was 1.4 (0.5), and that of S‐PIIINP 2.5 (1.2), ( P < 0.0001, CI 0.81 to 1.42). The 2‐month‐peak of S‐PICP was 1.6 (0.3), and at the same time the relative S‐PIIINP was still 1.7 (0.3) without any separate peak. Major infectious ( n = 8) and other (12) complications, exploratory procedures (22) and patients with abnormal pre‐operative propeptide levels (8) were studied separately. Two early deaths were excluded. Only major infection had a remarkable effect on the responses of S‐PICP (3/8) and S‐PIIINP (5/8). The results demonstrate the ability of extracellular matrix to adjust its turnover in response to major trauma and infection.