Loss of protein, immunoglobulins, and electrolytes in exudates from negative pressure wound therapy

Charles Wade, Steven Wolf, Reuben Salinas, John A. Jones, Racheal Rivera, Leslie Hourigan, Toney Baskin, John Linfoot, Elizabeth A. Mann, Kevin Chung, Michael Dubick

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: A relatively new technology in wound care, negative pressure wound therapy (NPWT), has become widely used for the management of open abdomens and soft tissue wounds and provides a means to collect wound exudate to quantify protein loss. Methods: A prospective observational study was conducted in surgical, trauma, or burn patients (8 patients with open abdomens and 9 patients with acute soft tissue wounds on NPWT). NPWT exudate was collected and assayed to characterize loss of protein, electrolyte, and immunoglobulins over multiple days of NPWT. Results: Total protein was present in open abdomen NPWT exudate, 2.9 ± 0.9 g/dL. In the soft tissue wound exudate, a similar mean concentration was found, 2.59 ± 0.6 g/dL (P =.34). Exudate concentrations of albumin, urea nitrogen, immunoglobulins, and electrolytes between wound types were also not significantly different. There were significant (P =.03) differences in the median volume of exudate, 1031 mL/d for open abdomens in contrast to 245 mL/d soft tissue wounds. Therefore, 24-hour losses of proteins and electrolytes were greater in patients with open abdomens than soft tissue wounds. Mean total protein loss was 25 ± 17 g/d for open abdomens and 8 ± 5 g/d for soft tissue wounds. Conclusion: There are significant losses of proteins in wound exudate. As there is no significant difference in the concentration of total protein between wound type, the rate of loss may be calculated as 2.9 g/dL times the volume of wound exudate. The rate of protein loss from wounds is similar to the presently assumed insensible loss rate of 12-25 g/d.

Original languageEnglish (US)
Pages (from-to)510-516
Number of pages7
JournalNutrition in Clinical Practice
Volume25
Issue number5
DOIs
StatePublished - Oct 1 2010
Externally publishedYes

Fingerprint

Negative-Pressure Wound Therapy
Exudates and Transudates
Electrolytes
Immunoglobulins
Wounds and Injuries
Proteins
Abdomen

Keywords

  • carrier proteins
  • exudates and transudates
  • negative-pressure wound therapy
  • nitrogen
  • nutrition requirements
  • wounds and injuries

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Loss of protein, immunoglobulins, and electrolytes in exudates from negative pressure wound therapy. / Wade, Charles; Wolf, Steven; Salinas, Reuben; Jones, John A.; Rivera, Racheal; Hourigan, Leslie; Baskin, Toney; Linfoot, John; Mann, Elizabeth A.; Chung, Kevin; Dubick, Michael.

In: Nutrition in Clinical Practice, Vol. 25, No. 5, 01.10.2010, p. 510-516.

Research output: Contribution to journalArticle

Wade, C, Wolf, S, Salinas, R, Jones, JA, Rivera, R, Hourigan, L, Baskin, T, Linfoot, J, Mann, EA, Chung, K & Dubick, M 2010, 'Loss of protein, immunoglobulins, and electrolytes in exudates from negative pressure wound therapy', Nutrition in Clinical Practice, vol. 25, no. 5, pp. 510-516. https://doi.org/10.1177/0884533610379852
Wade, Charles ; Wolf, Steven ; Salinas, Reuben ; Jones, John A. ; Rivera, Racheal ; Hourigan, Leslie ; Baskin, Toney ; Linfoot, John ; Mann, Elizabeth A. ; Chung, Kevin ; Dubick, Michael. / Loss of protein, immunoglobulins, and electrolytes in exudates from negative pressure wound therapy. In: Nutrition in Clinical Practice. 2010 ; Vol. 25, No. 5. pp. 510-516.
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AU - Wade, Charles

AU - Wolf, Steven

AU - Salinas, Reuben

AU - Jones, John A.

AU - Rivera, Racheal

AU - Hourigan, Leslie

AU - Baskin, Toney

AU - Linfoot, John

AU - Mann, Elizabeth A.

AU - Chung, Kevin

AU - Dubick, Michael

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AB - Background: A relatively new technology in wound care, negative pressure wound therapy (NPWT), has become widely used for the management of open abdomens and soft tissue wounds and provides a means to collect wound exudate to quantify protein loss. Methods: A prospective observational study was conducted in surgical, trauma, or burn patients (8 patients with open abdomens and 9 patients with acute soft tissue wounds on NPWT). NPWT exudate was collected and assayed to characterize loss of protein, electrolyte, and immunoglobulins over multiple days of NPWT. Results: Total protein was present in open abdomen NPWT exudate, 2.9 ± 0.9 g/dL. In the soft tissue wound exudate, a similar mean concentration was found, 2.59 ± 0.6 g/dL (P =.34). Exudate concentrations of albumin, urea nitrogen, immunoglobulins, and electrolytes between wound types were also not significantly different. There were significant (P =.03) differences in the median volume of exudate, 1031 mL/d for open abdomens in contrast to 245 mL/d soft tissue wounds. Therefore, 24-hour losses of proteins and electrolytes were greater in patients with open abdomens than soft tissue wounds. Mean total protein loss was 25 ± 17 g/d for open abdomens and 8 ± 5 g/d for soft tissue wounds. Conclusion: There are significant losses of proteins in wound exudate. As there is no significant difference in the concentration of total protein between wound type, the rate of loss may be calculated as 2.9 g/dL times the volume of wound exudate. The rate of protein loss from wounds is similar to the presently assumed insensible loss rate of 12-25 g/d.

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KW - nitrogen

KW - nutrition requirements

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