A pilot study evaluating protein abundance in pressure ulcer fluid from people with and without spinal cord injury

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000212 · Published: July 1, 2015

Simple Explanation

This study looks at the biochemistry of chronic pressure ulcers in patients with and without spinal cord injury (SCI). The goal was to measure and compare the levels of different substances, like inflammatory mediators, growth factors, and proteases, in wound fluid. The researchers found that the biochemical composition of pressure ulcers differs between people with and without SCI. This suggests that treatment options should be tailored to each group. The study also found that blood serum properties may not accurately reflect what's happening in the local wound environment. This means that relying solely on blood tests might not provide a complete picture of the wound's condition.

Study Duration

Not specified

Participants

29 subjects with SCI and 9 subjects without SCI

Evidence Level

Survey

Key Findings

1
Wound fluid concentrations were significantly different between subjects with SCI and subjects without SCI for total protein concentration and nine analytes, MMP-9, S100A12, S100A8, S100A9, FGF2, IL-1b, TIMP-1, TIMP-2, and TGF-b1.
2
Subjects without SCI had higher values for all significantly different analytes measured in wound fluid except FGF2, TGF-b1, and wound fluid total protein.
3
Subject-matched circulating levels of analytes and the standardized local concentration of the same proteins in the wound fluid were weakly or not correlated.

Research Summary

This pilot study investigated the biochemical profile of pressure ulcer wound fluid in individuals with and without spinal cord injury (SCI). It aimed to determine if differences exist in the concentration of inflammatory mediators, growth factors, cytokines, acute phase proteins, and proteases. The study found significant differences in wound fluid protein concentrations between the SCI and non-SCI groups for several key analytes, including MMP-9, S100A8/9/12, FGF2, IL-1b, TIMP-1/2, and TGF-b1. Non-SCI subjects generally had higher levels except for FGF2 and TGF-b1. The research also revealed a weak correlation between circulating blood serum levels and local wound fluid concentrations of the measured proteins, suggesting that systemic blood tests may not accurately represent the wound environment. The degree of motor and sensory impairment may affect the analyte concentration in pressure ulcer wound fluid.

Practical Implications

Tailored Treatment Options

The distinct biochemical profiles in pressure ulcers of SCI versus non-SCI patients suggest that treatment strategies should be customized to each population.

Local Wound Environment Focus

Given the weak correlation between blood serum and wound fluid, therapies should target the local wound environment rather than relying solely on systemic interventions.

Consider Neurological Impairment

The study indicates that the level and type of neurological impairment in SCI patients may influence wound healing, warranting further investigation and personalized care approaches.

Study Limitations

1
The subjects were not age-matched due to limitations in finding a suitable non-SCI population with pressure ulcers.
2
The site of wounds varied and was not matched between populations, which may contribute to the observed biochemical differences.
3
This is a pilot study with low subject numbers.

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