Production of VEGF and b-FGF in the drainage fluid from patients undergoing incisional hernia repair

Wound healing is a complex process involving interaction between different cell types, such as growth factors. Among these, vascular endothelial growth factors (VEGF) and basic fibroblast growth factors (b-FGF) are the most important. The aim of this study was to assess the production of VEGF and b-FGF in wound drainage fluid from patients undergoing incisional abdominal hernia repair. Ten female patients with abdominal midline incisional hernia undergoing surgical repair were included in this study. In all cases a closed suction drain was placed in the wound below the fascia and removed on postoperative day 4. Wound fluid was collected on the I, II, III and IV day and its amount at each time was recorded. VEGF and b-FGF production were evaluated as the quantity produced in 24 hours. In all patients the amount of drainage fluid from the surgical wound was highest on the I day after surgery, after which there was a significant reduction. VEGF production increased progressively after the operation proving significantly higher only on the IV day. The amount of b-FGF, in contrast, was higher on the I day, decreasing thereafter on the following postoperative days. Analysis of the production of growth factors in the drainage fluid has enabled us to better assess the events that occur following surgical wounds and has confirmed the physiology of the healing process and the possible use of these factors in modulating positive healing.