Acta Ortopédica Mexicana

Pacheco-Haro LJ, Chávez-Cadena MA
Preoperative lymphocytes as a factor related with delayed healing in hip surgery
Acta Ortop Mex 2012; 26 (4)

Language: Español
References: 14
Page: 224-227
PDF: 36.50 Kb.

[Fulltext - PDF]

ABSTRACT

Introduction: Historically, only substantial nutritional deficiencies have been recognized on time in surgical patients due to the technical difficulty of making the diagnosis. Preoperative nutritional assessment with biochemical and immunologic variables helps detect patients with malnutrition. The purpose of our study was to find out the role of the lymphocyte count in the preoperative complete blood count as a factor associated with delayed healing in hip surgery, and thus detect the patients at risk of complications. Methods: A study was conducted in patients undergoing hip surgery, from December 2008 to May 2009, and who were followed-up at the outpatient service. Results: A total of 48 patients were assessed; 21 patients (43.8%) underwent surgery due to an orthopedic condition, and 27 (56.3%) due to trauma. Lymphocyte counts included a minimum of 200 and a maximum of 9,600. Twenty-six patients had lymphocytes ‹ 1,500 with healing ranges from 10 to 30 days, and 22 patients had a count › 1,500 with healing ranges from 10 to 25 days. No differences were found in gender or in the traumatic or orthopedic condition. There was a statistically significant difference in favor of the group with lymphocytes › 1,500 cells/mm3. Conclusions: A strong relation was found between delayed healing and patients with lymphocytes ‹ 1,500 cells/mm3.


Key words: lymphocytes, healing, hip, surgery, evaluation.


REFERENCES

  1. Marín LA, Salido JA, López A, Silva A: Preoperative nutritional evaluation as a prognostic tool for wound healing. Acta Orthop Scand 2002; 73(1): 2-5.

  2. Gherini S, Vaughn BK, Lombardo AV Jr: Delayed wound healing and nutritional deficiencies after total hip arthroplasty. Clin Orthop 1993; 293: 188-95.

  3. Macari MZ, Cavenaghi FM, Komesu MC, Lunardi LO, Sala MS, Grisi M, et al: Immune cells depletion during wound healing as a long-term effect of undernutrition. Int J Morphol 2005; 23(1): 25-32.

  4. Lin F, Baldessari F, Crenguta C, Sato T, Chambers R, Santiago J, et al: Lymphocyte electrotaxis in vitro and in vivo. J Immunol 2008; 181: 2465-71.

  5. Watters C, Tredget E: Nutrition and wound healing. The Canadian Journal of CME 2002: 65-74.

  6. Aguilar O, Sánchez R, Figueroa S, Ávila G, Schalch P, Di Silvio M: Sistema de evaluación nutricional para pacientes quirúrgicos. Cir Ciruj 2003; 71: 45-9.

  7. Montero LA, Yáñez J, Hernández M, Ferrerios O, Pedrós L: Influencia de los parámetros nutricionales en cirugía de cadera. Rev Esp Cir Osteoart 1997; 32: 128-32.

  8. Gómez M, Utrilla L, Serastia E, Pérez JC: Estado nutricional en ancianos con fractura de cadera. Rev Esp Cir Osteoart 1997; 32: 133-7.

  9. Foss N, Jensen P, Kehlet H: Risk factors for insufficient perioperative oral nutrition after hip fracture surgery within a multi-modal rehabilitation programmed. Age Ageing 2007; 36(5): 538-43.

  10. Lumbers M, New S A, Gibson S, Murphy MC: Nutritional status in elderly female hip fracture patients: comparison with an age matched home living group attending day centers. Br J Nutr 2001; 85: 733-40.

  11. King T: Prevention of complications in orthopedic surgery secondary to nutritional depletion. Clin Orthop 1986; 1: 91-7.

  12. García S, Pérez G, Sanavia E, De Juanes J R, Arrazola MP, Resines C: Control nutricional en pacientes de traumatología. Nutr Hosp 2008; 23(5): 493-9.

  13. Fuhrman M: Wound healing and nutrition. Top Clin Nutr 2003; 18(2): 100-10.

  14. Arnold M, Barbul A: Nutrition and wound healing. Plastic and Reconstructive Surgery 2006; 117(78): 42S-58S.