Effects of cryoprecipitate on the healing of chronic wounds.

Basic research has promise for clinical wound healing. Purified wound healing growth factors are not available for clinical use, but they are present in plasma and platelets and have been used in patients. Chronic wounds would seem to be good for study since the wound surface is easily measured and the patient is anxious for progress. We have done a double-blinded pilot study using autologous cryoprecipitate on chronic wounds. Three of six patients showed wound healing progress; but only one patient's wounds healed permanently. One patient developed new diabetic ulcers, and one patient failed to keratinize epithelialized skin. Cryoprecipitate may promote wound healing, but further work awaits more purified healing factors. Simple measurement of the surface area of a chronic wound may not be adequate to describe all the processes of healing.

Quality control by blind sample analysis.

Quality control efforts may be biased consciously or unconsciously. External programs are handicapped by the time lapse before poor performance is disclosed. Bias induced into internal and external quality control efforts by special handling may be eliminated through submission of blind samples originating from wards, clinics, or phlebotomy areas. Evaluation of laboratory performance is obtained under conditions similar to those experienced by the patients' specimens. Calibration performance by operators, which varies considerably, can be monitored. Laboratory clerical activity can be scrutinized and errors quantitated and corrected. Perhaps most important, the sum of the effects of specimen handling and analytic variability can be determined.

Urinary chemistry. A new CAP program.

A pilot survey program for urinary chemistry was implemented by the College of American Pathologists during the year 1976. The nine analytes selected for the program were amylase, calcium, phosphorus, sodium, potassium, creatinine, osmolality, 17-ketosteroids and total protein. Data obtained from more than 230 enrolled laboratories indicate deficiencies in assay performance for amylase, 17-ketosteroids and total protein as measured by consensus evaluation. Acceptable performance was apparent for the remaining analytes.

Effects of specimen evaporation on quality control.

Serum samples stored in a refrigerator and in ambient room air were studied for alteration of mean weight and mean concentration values. The storage period selected was four hours and the samples were variously stored exposed, refrigerated, and covered with a sample tray cover and by an airtight cover. Some storage procedures produced values more than 2 SD from the mean for many analytes. These findings were confirmed by a parallel study revealing a decrease of sample weight after the four-hour storage period. Storage at 4 C in sample cups covered by an airtight opaque shield alleviated the problem. Failure to treat external quality control sample pools in the same way as other samples will produce unexplained out-of-control results.