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World Journal of Surgery
Published in: World Journal of Surgery 9/2020

01-09-2020 | Wound Debridement | Original Scientific Report

Expression of Pancreatic Stone Protein is Unaffected by Trauma and Subsequent Surgery in Burn Patients

Authors: Holger J. Klein, Philipp K. Buehler, Pia Niggemann, Daniel Rittirsch, Riccardo Schweizer, Matthias Waldner, Pietro Giovanoli, Paolo Cinelli, Theresia Reding, Rolf Graf, Jan A. Plock

Published in: World Journal of Surgery | Issue 9/2020

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Abstract

Background

Altered levels of pro-inflammatory markers secondary to trauma or surgery present a major problem to physicians in being prone to interfere with the clinical identification of infectious events.

Methods

Patients admitted to Zurich Burn Center between May 2015 and October 2018 with burns ≥10% total body surface area (TBSA) and without infection. Longitudinal analysis of the time course of PSP and routine inflammatory biomarkers [procalcitonin (PCT), C-reactive protein (CRP) and white blood cells (WBC)] over two days after (a) trauma with initial debridement and (b) subsequent burn surgeries was performed. The influence of TBSA, abbreviated burn severity index (ABSI), age and length of operation was investigated using a linear mixed effect regression model.

Results

Sixty-six patients (15 female) were included with a mean age of 45.5 ± 18.3 years, median TBSA of 22% (IQR 17) and mean ABSI score 6.8 ± 2.7. PSP was the only biomarker that showed no association with any of the baseline characteristics. Additionally, PSP serum levels did not change over time neither after the burn trauma (p = 0.832) nor after secondary procedures (p = 0.113), while PCT levels increased significantly after the trauma (p < 0.001). Similarly, CRP serum levels were elevated significantly after both trauma and surgery (p < 0.001), whereas WBC values demonstrated a significant decline after the trauma (p < 0.001).

Conclusion

Established biomarkers (WBC, CRP and PCT) demonstrate decisive alterations after tissue destruction caused by burn injuries and subsequent surgical interventions. The robustness of PSP serum levels toward these inflammatory insults is a quality criterion for an upcoming sepsis biomarker.
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Metadata
Title
Expression of Pancreatic Stone Protein is Unaffected by Trauma and Subsequent Surgery in Burn Patients
Authors
Holger J. Klein
Philipp K. Buehler
Pia Niggemann
Daniel Rittirsch
Riccardo Schweizer
Matthias Waldner
Pietro Giovanoli
Paolo Cinelli
Theresia Reding
Rolf Graf
Jan A. Plock
Publication date
01-09-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 9/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05589-w

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