Specific C-reactive protein measurements in plastic surgery

The early detection of postoperative signs of infection can help to obviate serious consequences. C-reactive protein (CRP) is a highly sensitive measure of inflammatory changes. Concise knowledge of standard concentrations of CRP after various operations would allow the differentiation between a physiological rise and the interpretation of CRP as a warning sign. The aim of this study was to establish standard curves for CRP reactivity for common operations in plastic surgery and to assess the validity of CRP as a prognostic indicator of infective complications. Four groups of 30 patients each had either breast reduction, abdominoplasty, submuscular breast augmentation or exchange of breast implants. CRP concentrations were measured once preoperatively and on eight consecutive days postoperatively. CRP peak values were found throughout postoperative days 3 to 5. Concentrations on days 2 and 7 were significantly different from day 4 (p<0.04). Patients who had no sharp decline in CRP after its peak developed complications in their future postoperative course. There was significant correlation between the amount of resected tissue and CRP concentrations (r=0.78, p<0.005). Our results suggest that knowledge of standard alterations in postoperative CRP concentrations increases the early detection of complications. No sharp decline in CRP after day 5 is a warning sign. The use of specific standard curves allows a comparative assessment of actual, individual concentrations of CRP.