Fibroneetin concentration is much lower in wound exudate from the zone of operation for postoperational ventral hernia than in blood plasma. It gradually increases, reaching the plasma level before the end of exudation and wound healing.
Key Words: fibronectin; wound exudate; postoperational woundsIn animal experiments we have shown that the healing of clean wound is faster against the background of weak exudation and the emergence of polyblasts, macrophages, and fibroblasts with proliferation and formation of collagen fibers [1].Then we have found that the concentration of fibronectin (FN) rapidly increases in a culture of fibroblasts for grafting into a burn, and the graft is taken when FN concentration in the culture medium is 49.9-5.0 ~tg/10 ~ cells. Generally, this concentration is reached on the 3rd day of culturing. These observations imply that flbroneetin has a role in wound healing.Blood content of soluble FN correlates with functioning of the reticuloendothelial system [4]. The decreases in plasma content of FN in bums, traumas, including surgical operations, shock, and sepsis [2,3, 5] is due to massive utilization of FN as a "universal glue": an opsonin which prepares bacteria and cell degradation products for phagocytosis.Fibroneetin forms complexes with the products of collagen degradation and with gelatin. These complexes increase the permeability of intestinal wall, thus impairing bacterial translocation [4].Insoluble FN serves structural functions. It is an excellent marker of the nutrition status, since its half-life in the plasma is 15-20 h. Plasma FN content immediately increases in response to enhanced Department of Thermal Injuries, A. V. Vishnev'skii Institute of Surgery, Russian Academy of Medical Sciences, Moscow nutrition, while the levels of the conventional markers transferrin and albumin still remain unchanged [3].Our goal was to study the relationship between the rate of healing of postoperational wounds on FN content in wound exudate.
MATERIALS AND METHODSFibroneetin content was measured in blood plasma and exudate formed in a postoperational wound after extensive reconstructive surgery for ventral hernia. There was no purulent inflammation; however, exudate was accumulated in tightly sutured postoperational wound during several days after operation. It was removed through a drainage tube at the level of subcutaneous fatty tissue. Plasma and exudate FN contents were determined by immunoturbidimetric method using Boehringer Mannheim kits.
RESULTSOn average, exudation lasted 4-6 days, although in 3 out of 14 patients it was observed for 12 days (Fig. 1). Within the first 2-3 days FN content in the exudate was 9-88 ~tg/ml. This is much lower than normal plasma FN level presumably due to massive utilization of FN after the operation. Plasma FN content was 228+28 ttg/ml. Then it increased to 276+38 t~g/ml and reached a value of 380+30 ~g/ml. The same tendency in the dynamics of exudate FN
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