BIOCHEMICAL MONITORING OF WOUND-HEALING - PMN ELASTASE IN DIFFERENT COURSES OF WOUND-HEALING AFTER TRAUMATOLOGICAL-ORTHOPEDIC SURGERY

Laboratory parameters are of proven value in the diagnosis of early po stsurgical infections, since clinical aspects cannot always be clearly defined. Neutrophil granulocytes (PMN) are major inflammatory cells t aking effect following ingestion and degradation of foreign material, such as bacteria and cell debris, for example after mechanical trauma. In patients who had undergone surgery we monitored the course of plas ma PMN elastase in uncomplicated wound healing (n=22), in uncomplicate d wound healing associated with secondary infections (n = 6), and in d efective wound healing (manifestation of a bacterial wound infection: n = 3; wound infection already manifest at the time of entry on study: n = 11). Surgical trauma was accompanied by an increase in PMN elasta se and C-reactive protein (CRP) in all patients studied, reaching a ma ximum within the first 3 postsurgical days. When a bacterial wound inf ection became manifest during the course of healing there was a highly significant difference on the 4th postsurgical day (P < 0.01) compare d with the group with uncomplicated healing. Since PMN elastase can no w be determined automatically with an autoanalyser and a commercial ki t and its discriminatory time point is as soon as 4 - 5 days after sur gery, it is suggested that this marker should be determined routinely together with CRP in traumatology.