Abstract
The coagulation factor XIII is known to play an important role in wound healing. However, there are few reports about factor XIII in the field of orthopaedic surgery. We measured the serum level of coagulation factor XIII in 30 patients with orthopaedic disorders. The patients were 12 males and 18 females, with an average age of 45.5 years.
13 patients had musculoskeletal tumors (malignant in 5 patients and benign in 8 patients), 4 patients had spinal disorders and 13 patients had arthropathies.
Before operation, there were 6 patients whose level of factor XIII was lower than normal. The recombinant coagulation factor XIII (Fibrogammin) was used for the six patients whose wound healing was delayed. Administration of the factor XIII improved their wound healing. The level of factor XIII in the pateints with musculoskeletal tumors had a tendency to be lower than that of those with other orthopaedic disorders. We could not detect any correlation between the level of factor XIII and other factors; age, duration of the operation, and the amount of blood loss. However, the level of factor XIII in patients who lost large amount of blood (over 3000ml) during operation was very low.
These results suggest that it is important to check the level of factor XIII before and after invasive operation such as excision of musculoskeletal tumor, hindquarter amputation and spinal operation using wide instrumentation, and to consider using factor XIII for patients with impaired wound healing.