Circulating fibronectin depletion in burned patients: relationship to development of infection and prognostic value.

Abstract

The time course of the level of plasma fibronectin (PFN) and its relationship to severity of injury, infection, and prognosis were studied in 27 burn patients with body surface area (BSA) burn greater than 20%. PFN was measured daily or every two days using a laser nephelometer. During the first four postburn days, a decrease in PFN was observed that was significant on days 2 and 3. On postburn day 2, a positive correlation was found between PFN decrease and extent of injury. The decrease was of high prognostic value. Between postburn days 4 and 16, PFN levels of infected patients were significantly lower than those of noninfected ones, but the onset of infection was not preceded by any significant decrease in PFN levels. This study offers arguments in favor of a close relationship between PFN deficiency and sepsis in burn patients, but it is impossible to assert that this deficiency plays a major role in the occurrence of infection.