Elsevier

Surgery

Volume 131, Issue 3, March 2002, Pages 338-343
Surgery

Original Communications
Premenopausal women deposit more collagen than men during healing of an experimental wound*,**

https://doi.org/10.1067/msy.2002.119986Get rights and content

Abstract

Background. From a post hoc analysis a hypothesis was generated that women deposit more collagen in a surrogate test wound than men. The purpose of this study has been to verify this hypothesis prospectively in a controlled study. Methods. Post hoc analyses were done on 37 volunteers (study A). The prospective trial included 47 smoking volunteers (study B). Outcome measures were deposition levels of collagen (hydroxyproline) and protein during a period of 10 days in subcutaneously implanted tubes of expanded polytetrafluoroethylene. Results. The mean increments of collagen deposition levels in women as compared with men were 56% (P <.01) in study A and 74% (P <.001) in study B. The mean increase in the ratio collagen/total protein was 74% (P <.001) and 69% (P <.001), indicating that the increase was specific for collagen. Conclusions. The studies show that deposition in a miniature subcutaneous test wound of collagen, but not noncollagenous protein, is promoted in women as compared to men. These findings may relate to the observation in some reports indicating higher rates of compromised postoperative wound healing in men. (Surgery 2002;131:338-43.)

Section snippets

Material and methods

Healthy volunteers recruited from hospital staff or among university students were included. Exclusion criteria were age younger than 18 years, diabetes mellitus, pregnancy, allergy to local anesthetics, and recent medication with corticosteroids, nonsteroidal anti-inflammatory drug, or aspirin. The collection of data was obtained from 2 independent studies, A and B.

Results

Both studies were well matched with regard to age between the genders. The rate of smokers was balanced between the genders in study A. In study B there was a significant 5% mean elevation of body mass index in the male group of volunteers (P <.05). The finding of significantly higher blood concentrations of hemoglobin and creatinine related to male gender was expected (Table).

Discussion

The present 2 independent trials are the first to demonstrate that premenopausal women deposit more collagen in a test wound than men. The deposition of collagen relative to total protein in the ePTFE implant was also significantly elevated, suggesting that the increase of collagen deposition in women is specific. In the prospective trial (study B), which included only smoking volunteers, the difference between men and women was found despite the inhibiting effects of cigarette smoking on

Acknowledgements

The review of the manuscript by Dr Michael Crawford and the skilled work by laboratory technicians Rikke Roel and Annie Høj are appreciated.

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    *

    Supported in part by Coloplast A/S, Denmark and The Foundation of A. & J. Louis Hansen, Denmark.

    **

    Reprint requests: Professor Finn Gottrup, MD, DMedSci, Copenhagen Wound Healing Center, Dept S15, Bispebjerg University Hospital, DK-2400 Copenhagen NV, Denmark.

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