Neutrophil extracellular trap formation index predicts occurrences of deep surgical site infection after laparotomy

Abstract

Background: Deep surgical site infections (DSSIs) are serious complications after laparotomy. Neutrophil extracellular traps (NETs) play a vital role in the development of DSSI. Here, we focused on a new approach to predicting the occurrence of DSSI through the detection of the NET formation index (NFI), and compared its prediction ability with other clinical infection indicators. Methods: Patients who received laparotomy were prospectively enrolled in this study. General information, APACHE II score, SOFA score, and serum infection indicators were recorded. The postoperative abdominal drainage fluid was collected within 3 days after the operation for quantification of the NFI.Results: A total of 92 consecutive patients were included, with 22 patients were diagnosed with DSSI.The NFI in the DSSI group was 32.70%±19.33% while the corresponding index was 10.70%±8.25% in the non-DSSI group (P<0.01). The mean APACHE II and SOFA score had significant differences between the two groups. The NFI was positively correlated with the APACHE II score (P<0.01, r=0.269) and SOFA score (P=0.013, r=0.258). Patients with a high NFI (NFI >13.86%) had a higher risk of developing DSSI.According to the receiver operating characteristic (ROC) curve, the area under the ROC curve (AUC) of the NFI, C-reactive protein (CRP) and procalcitonin (PCT) were 0.912, 0.748 and 0.731, respectively. Conclusions:In this cohort of surgical patients, the quantification of the NFI had a considerable predictive value for early identification of DSSI. The NFI in drainage fluid turned out to be a more sensitive and specific predictor of DSSI than serum infection indicators including CRP and PCT.

Neutrophil extracellular traps drive intestinal microvascular endothelial ferroptosis by impairing Fundc1-dependent mitophagy

“…Nevertheless, overproduction of NETs may lead to local tissue damage, and NETs may act as a proinflammatory agent [ 8 ]. Our previous research has demonstrated that circulating NET biomarkers are linked to disease severity and clinical prognosis [ 15 , 53 ]. In the current study, we observed similar findings, as both MPO-DNA and CitH3-DNA complexes, which serve as intestinal NET biomarkers, were found to be elevated in serum and intestinal samples obtained from patients experiencing II/R injury.…”

Neutrophil Extracellular Traps: A Crucial Factor in Post-Surgical Abdominal Adhesion Formation

“…Several studies suggest that the recruitment and activation of neutrophils at the site of injury may contribute to adhesion formation through the release of pro-inflammatory mediators and the promotion of fibroblast activation [ 12 , 13 , 14 ], raising further questions on their particular significance. Duan Z et al’s work revealed that measuring the neutrophil extracellular trap formation index (NFI) in postoperative drainage fluid offers a more sensitive and specific method for early prediction of deep surgical site infections compared to traditional serum infection indicators like CRP and PCT [ 15 ]. Consequently, the objective of this review was to examine research focusing on the role that neutrophils play in abdominal adhesions.…”