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Review Question - QID 122

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QID 122 (Type "122" in App Search)
A 40-year-old male who sustained an open pilon fracture 2 weeks ago is scheduled for a below-the-knee amputation (BKA). What laboratory value is the best predictor for wound healing?

serum albumin level

89%

1615/1808

total protein level

7%

129/1808

calcium levels

0%

9/1808

C-reactive protein

2%

34/1808

ESR

0%

5/1808

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Based on the choices above, the most important predictor of wound healing is the serum albumin level.

Wound healing is based on several factors, which include the vascular status, the immune status, and the nutritional status of the patient. Some important clinical findings include an ankle brachial index (ABI) > 0.45, a total lymphocyte count > 1500/mm3 and a serum albumin > 3.0 g/dL.

Kay et al. discuss the importance of the nutritional status in wound healing after lower extremity amputation procedures. They found eleven of 25 patients who were malnourished sustained either local or systemic complications postoperatively. They recommend that patients should undergo nutritional screening prior to elective lower extremity amputations, to help optimize their wound healing.

Incorrect Answers
Answer 2: While total protein is a marker of nutritional status, it is not as sensitive as the serum albumin for wound healing potential.
Answers 3, 4, 5: Calcium levels, C-reactive protein and ESR are not markers of wound healing

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