Abstract
Fibronectin and factor XIII play a major role in blood coagulation cascade and contribute to wound healing and phagocytic function of macrophages. Spinal cord injured (SCI) patients with end-stage renal disease (ESRD) have been shown to exhibit a variety of coagulation abnormalities, a high incidence of infection and poor healing pressure ulcers. Earlier studies in SCI patients with no discernible renal disease revealed a marked rise in plasma fibronectin in patients with fast healing pressure ulcers. However, no significant rise is found in those with poor healing ulcers. We compared plasma concentrations of fibronectin and factor XIII in a group of 13 SCI-ESRD patients with those of a normal control group. Despite the presence of pressure ulcers, the SCI-ESRD patients as a group failed to show a significant rise in plasma fibronectin concentration. In addition, the mean plasma factor XIII value in the SCI-ESRD group was not significantly different from that of the normal control group. Accordingly, the combination of SCI, ESRD and associated conditions seems to impair the patient's ability to mount a rise in plasma fibronectin concentration in response to the presence of pressure ulcers. Failure of SCI-ESRD patients to produce a rise in plasma fibronectin concentration may, in part, account for the poor healing property of pressure ulcers in this population.
Similar content being viewed by others
Article PDF
References
Eltorai I, Chung B 1977 The management of pressure sores. Journal of Dermatologic Surgery and Oncology 3: 507–511.
Falcone P A, Bonaventura M, Turner D C 1984 The effect of exogenous fibronectin on wound breaking strength. Plastic and Reconstructive Surgery 74: 809–812.
Mirahmadi M K, Barton C, Vaziri N D Gordon S, Penera N 1983 Nutritional evaluation of hemodialysis patients with and without spinal cord injury. Journal of the American Paraplegia Society 6: 36–40.
Mosher D F 1980 Fibronectin. Progress in Hemostasis and Thrombos 5: 111–151.
Mosher D F 1987 Fibronectin—Relevance to Hemostasis and Thrombosis. In: Hemostasis and Thrombosis, 2nd edn. J B Lippincott Company, Philadelphia, pp. 210–218.
Nagleschmidt M, Becker D, Bonnighoff N, Engelhardt GH 1987 Effect of fibronectin therapyand fibronectin deficiency on wound healing: A study in rats. Journal of Trauma 27: 1267–1271.
Saba T M, Blumenstock F A, Shah D M . et al. 1984 Reversal of fibronectin and opsonic deficiency in patients: A controlled study. Annals of Surgery 199: 87–96.
Vaheri A, Salonen E M, Varztio T, Hedman K, Stenman S 1983 Fibronectin and Tissue Injury—Vessel Wall. Praeger. Eastbourne pp. 161–171.
Vaziri N D, Cesario T, Mootoo K . Zeien L, Gordon S, Byrne C 1982 Bacterial infections in patients with end-stage renal disease associated with spinal cord injury. Archives of Internal Medicine 142: 1273–1276.
Vaziri N D, Winer R L, Alikhani S et al. 1985A Antithrombin deficiency in end-stage renal disease associated with paraplegia: Effect of hemodialysis. Archives of Physical Medicine and Rehabilitation 66: 307–309.
Vaziri N D, Winer R L, Alikhani S . et al. 1985B Intrinsic coagulation pathway in end-stage renal disease associated with spinal cord injury treated with hemodialysis. Artificial Organs 9: 155–159.
Vaziri N D, Winer R L, Alikhani S . et al. 1986 Extrinsic and common coagulation pathways in end-stage renal disease associated with spinal cord injury. Paraplegia 24: 154–158.
Vaziri N D, Winer R L, Patel B . et al. 1987 Protein C abnormalities in spinal cord injured patients with end-stage renal disease. Archives of Physical Medicine and Rehabilitation 68: 791–793.
Vaziri N D, Eltorai I, Gonzales E, Winer R L, 1990 Pressure ulcer, fibronectin and related proteins in spinal cord injured patients. Archives of Physical Medicine and Rehabilitation (In Press).
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vaziri, N., Winer, R., Gonzales, E. et al. Fibronectin and factor XIII in spinal cord injured patients with end-stage renal disease. Spinal Cord 29, 156–160 (1991). https://doi.org/10.1038/sc.1991.22
Issue Date:
DOI: https://doi.org/10.1038/sc.1991.22