Levels of plasma fibrinopeptide-A during surgery and the severity of the operation.

ABSTRACT

There is evidence to suggest that the rise of fibrinopeptide A (FPA) during surgery is influenced by tissue thromboplastin released during tissue damage. To investigate whether FPA correlates with the severity of the damage of the operation, 39 patients were recruited and venous blood samples were taken pre-operatively, during skin incision, during bowel manipulation and post-operatively for the assay of FPA. The operations are grouped as minor (A), moderate (B), major (C) and very major (D). The peak FPA levels occurred during bowel manipulation in every degree of operations, and ranged between 6.0 to 22.2 pmol/ml. There was a tendency that peak FPA values rose according to the severity of the surgery, however only very major operations (D) are significantly higher when compared with minor operations (A) (p < 0.01). There was no good correlation between peak FPA levels and length of skin incision (p = 0.83, r = 0.04) as well as peak FPA levels and duration of operation (p = 0.90, r = 0.03). Significantly higher levels of FPA in very major operation (D) was due to more excessive tissue damage during surgery, while due to relatively minimal tissue injury, size of skin incision correlated poorly with FPA.