[Impact of surgical aggression and postoperative septic problems on fibronectin levels]

The following study has been carried out in order to assess the repercussion of surgery on fibronectin (F) levels and its course, whether or not septic complications are presented. The F, albumin (ALB), prealbumin (PREALB), retinol binding protein (RBP) and alpha-1-glycoprotein (GLYCO) levels were controlled in 37 patients (29 undergoing scheduled digestive tract surgery and 8 undergoing heart surgery), through preoperative and postoperative tests every three days. A group of 40 healthy controls was taken as reference. Group I contained 19 patients free of septic complications, statistically significant changes were observed in PREALB and RBP levels but not in F, although a decrease was observed which return to normal by the third test. Group II contained 18 patients which were subdivided into: a) 12 patients suffering from brief septic complication without known focus of infection and, b) 6 patients suffering from more severe septic complication with known focus of infection. The IIA subgroup showed a significant decrease in all protein levels, returning to normal levels by the sixth or seventh day. Subgroup IIB showed lower F levels, which did not return to normal before the ninth day. CONCLUSION. Preoperative controls were similar in I and IIa, while IIB showed significantly lower values. Although F decreased in the first preoperative control, it was not statistically significant. Patients not suffering from complications showed F recuperation within the first week, which was not the case of septic patients. Due to the wide number of functions of F and of the factors that influence it, we believe it should not be interpreted on a single basis a nutritional parameters.