title: Increased skin autofluorescence after colorectal operation reflects surgical stress and postoperative outcome.
abstract: BACKGROUND
  Abdominal surgery is a major oxidative stress effector. The increase in oxidative stress has been related to postoperative complications. Oxidative stress leads to the formation and accumulation of oxidation protein end products, which exhibit autofluorescence (AF) and induce inflammatory reactions.
  
  
  METHODS
  Skin AF was assessed perioperatively in 40 consecutive colorectal surgery patients until discharge. Duration of surgery, estimated blood loss, and urinary production per hour were analyzed as measures of surgical stress. The clinical occurrence of anastomotic leakage, systemic infections, and cardiopulmonary complications within 30 days of surgery were analyzed.
  
  
  RESULTS
  A perioperative increase in skin AF of 19 ± .2% was observed. Duration of operation and blood loss were independently associated with the perioperative increase in skin AF. Skin AF correlated with C-reactive protein levels postoperatively. American Society of Anesthesiologists classification, duration of operation, and preoperative and perioperative increases in AF were independently associated with postoperative complications.
  
  
  CONCLUSIONS
  This is the first study to demonstrate an association between skin AF and surgical stress and outcomes, which may rate the condition of a patient after operation.
authors: Department of Surgery, Isala Clinics, Zwolle, The Netherlands.
authors: Henk Willem D
authors: HW
authors: Pol
authors: Els
authors: E
authors: Sibma
authors: Clark J
authors: CJ
authors: Zeebregts
authors: Erik G J M
authors: EG
authors: Pierik
authors: Robbert
authors: R
authors: Meerwaldt
mesh_terms: D016063:Blood Loss, Surgical; D001794:Blood Pressure; D002097:C-Reactive Protein / Q000032:analysis; D003106:Colon / Q000601:surgery*; D005260:Female; D005453:Fluorescence; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018384:Oxidative Stress; D011183:Postoperative Complications; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012867:Skin / Q000378:metabolism*; D013050:Spectrometry, Fluorescence; D013997:Time Factors; D014556:Urine
chemical_list: D002097:C-Reactive Protein