Goodson W H, Lopez-Sarmiento A, Jensen J A, West J, Granja-Mena L, Chavez-Estrella J
Ann Surg. 1987 Mar;205(3):250-5. doi: 10.1097/00000658-198703000-00006.
In a study of wound healing at high altitude, subcutaneously implanted PTFE tubes were used to stimulate and measure accumulation of wound hydroxyproline (an index of collagen) in 26 patients who had appendectomy and in 38 patients who had cholecystectomy. Patient age, length of surgery, and postoperative recovery seemed to predict better healing in patients who had appendectomy, but there was a difference in the preoperative illness of the two groups: acute cholecystitis was treated medically and cholecystectomy performed after resolution of the acute phase of illness, whereas patients who had appendectomy were taken to surgery as soon as a diagnosis was made. It was observed that patients who had appendectomy accumulated 20% less hydroxyproline than patients who had cholecystectomy (p less than 0.02), and that the depression of hydroxyproline accumulation was significantly related to length of preoperative illness (p = 0.008). This decrease in wound hydroxyproline accumulation is attributed to the acute preoperative illness. Conceptually, this is a unique situation since the brief illness did not produce lasting debility, and the source of illness, the inflamed appendix, was not present during healing. This indicates that even a brief preoperative illness has a more prolonged influence on postoperative healing than usually anticipated.
在一项关于高原伤口愈合的研究中，对26例行阑尾切除术的患者和38例行胆囊切除术的患者，皮下植入聚四氟乙烯管以刺激并测量伤口羟脯氨酸（胶原蛋白指标）的蓄积情况。患者年龄、手术时长及术后恢复情况似乎可预测阑尾切除术后患者的愈合情况更佳，但两组患者术前疾病情况存在差异：急性胆囊炎采用药物治疗，在疾病急性期消退后行胆囊切除术，而阑尾切除患者一经确诊即行手术。结果发现，阑尾切除患者的羟脯氨酸蓄积量比胆囊切除患者少20%（p<0.02），且羟脯氨酸蓄积量的降低与术前疾病时长显著相关（p = 0.008）。伤口羟脯氨酸蓄积量的这种降低归因于术前急性疾病。从概念上讲，这是一种独特的情况，因为短暂的疾病并未导致持久的虚弱，且在愈合过程中不存在疾病根源即发炎的阑尾。这表明，即使是短暂的术前疾病对术后愈合的影响也比通常预期的更为持久。
