Growth factor profiles in intraperitoneal drainage fluid following colorectal surgery: Relationship to wound healing and surgery

Cytokines and growth factors are important at each stage of wound healing. This study aims to determine the changing profiles of these factors in intraperitoneal drainage, acute wound fluid, following colorectal surgery, and to correlate levels to wound healing and surgical outcomes. Acute wound fluid samples (n = 52 patients) were collected daily from postoperative day 1 until drain removal. Levels of cytokines (interleukins-6 and -1beta and tumor necrosis factor-alpha) and epidermal growth factor, platelet-derived growth factor, vascular endothelial derived growth factor, basic fibroblast growth factor, and transforming growth factor-beta1 were determined by enzyme-linked immunosorbent assay. A significant negative correlation emerged between the levels of interleukin-6, epidermal growth factor, platelet-derived growth factor, and basic fibroblast growth factor and the postoperative day, e.g., basic fibroblast growth factor : day 1, 695, median (29-2,806, range) pg/ml; day 2, 249 (1-1,784); day 3, 94 (0-722); day 7, 22 (0-326) (p < 0.05, Spearman's correlation). Levels appeared to relate to the stage of wound healing. Several factors, in particular interleukin-1beta and tumor necrosis factor-alpha levels, correlated with surgical outcomes such as the need for a defunctioning stoma and/or postoperative complications. Cytokines and growth factors are involved in normal wound healing, and their levels in acute wound fluid may act as markers of wound healing and surgical outcome.