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Changes in serum and exudate creatine phosphokinase concentrations as an indicator of deep tissue injury: a pilot study
Authors:Yunita Sari  Gojiro Nakagami  Ai Kinoshita  Lijuan Huang  Kohei Ueda  Shinji Iizaka  Hiromi Sanada  Junko Sugama
Affiliation:1. Y Sari, BN, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, Department of Nursing Science, Sudirman University, Purwokerto, Indonesia;2. G Nakagami, MHS, RN, Japanese Society for the Promotion of Sciences, Tokyo, Japan, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;3. A Kinoshita, PhD, MT, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;4. L Huang, MHS, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;5. K Ueda, BSN, RN, PHN, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;6. S Iizaka, BSN, RN, PHN, Department of Gerontological Nursing, Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;7. H Sanada, PhD, WOCN, RN, Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;8. J Sugama, PhD, RN, Department of Clinical Nursing, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
Abstract:Deep tissue injury (DTI) is difficult to detect in the early phase. Creatine phosphokinase (CPK) as a muscle enzyme could represent a promising indicator of DTI. However, serum CPK levels reflect the systemic condition rather than the local wound environment. Wound exudates can be indicative of the local wound environment. This study aimed to investigate the usefulness of CPK levels in wound exudates as an indicator of DTI. Rats were divided into control, 6 hours 10‐kg and 6 hours 20‐kg loading groups. Serum samples were obtained before wounding, and at 8 and 12 hours, and 1, 2 and 3 days after wounding, while exudate samples were obtained on days 2 and 3. Serum CPK levels were markedly increased in the 10‐kg and 20‐kg groups at 8 and 12 hours after loading compared with the baseline value and control group, but decreased to the normal level on day 1. In both loading groups, exudate CPK levels were high on day 2 and decreased on day 3. Muscle necrosis was more severe in the 20‐kg group than in the 10‐kg group by histological examination. This is the first study to indicate the potential of CPK in wound exudates as an indicator of DTI.
Keywords:Creatine phosphokinase  Deep tissue injury  Exudate  Serum
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