SERUM AND WOUND ENVIRONMENT C-REACTIVE PROTEIN, VIABLE BACTERIA AND SICKNESS BEHAVIOR SYMPTOMS IN NON-HEALING
Joyce Stechmiller, RN PhD, Debra Lyon, RN PhD, Daniel Gibson, PhD, Michael Weaver, RN PhD, Joie Whitney, RN PhD, Jung Kim, RN PhD, Gregory Schultz, PhD
University of Florida, Gainesville, FL, USA
Background: Our central hypothesis is that the interrelated cellular and molecular mechanisms whose immune activation contributes to the development and persistence of chronic venous leg ulcers (CVLU) and systemic inflammation that may also lead to the development and severity of sickness behaviors (SB) (pain, fatigue, depression). Methods: Blood was collected from patients at 0, 4, & 8 weeks and the serum was assayed for CRP via ELISA. Wound swabs and curettage were collected weekly. The curettage was immediately processed and assayed for viable total and biofilm bioburdens. The swabs were extracted with PBS-Tween and assayed for CRP via ELISA. SB were measured with instruments and interviews. Results: Preliminary findings on 9 patients with elevated serum or wound fluid CRP also had elevated bioburdens. The wound fluid CRP data were more varied and lower than have been previously reported. We found that the total protein values for the collected wound fluid were abnormally low, and therefore CRP may be understated due to inadequate fluid collection and over dilution during collection. SB findings revealed mild to moderate symptoms. Conclusions: This study is on-going and will yield more samples to determine if the emerging patterns remain and correlations with SB. Furthermore, additional multi-molecular assays will be performed once enough samples have been collected; which may also help explain the biological variance we have seen.
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