Impact of Perioperative 5FU on Surgical Wound Healing

This is a descriptive comparative study of surgical wound healing in patients receiving experimental perioperative 5-FU. One of the most critical nursing skills is the accurate and timely detection of impaired wound healing. This skill is particularly significant under conditions in which healing may be compromised. Currently, there is no reliable, valid tool to guide the nursing assessment of these wounds. This study will test such a tool to meet this need. Researchers believe that the best chance of improving long-term survival among colon cancer patients who undergo curative surgery is to administer appropriate adjuvant chemotherapy during the immediate postoperative period. Physicians at Walter Reed Army Medical Center are part of a multi-center group conducting a Phase III drug trial of perioperative 5-Fluorouracil (5-FU). This study is known as CALGB 9395. There is controversy over the impact of 5-FU in wound healing. The purpose of our study is to describe the impact of systemic intravenous administration of 5-FU in abdominal surgical wound healing during the early postoperative period. A second purpose is to establish reliability and validity of a clinically relevant instrument for non-invasive assessment of surgical wound healing. A convenience sample of patients already randomized into experimental and control groups by CALGB 9395 will be used. Researchers will assess the subject's surgical wounds daily during their postoperative hospitalization using the Modified Wound Assessment Inventory (MWAI). Holden (1985) developed a Wound Assessment Inventory (WAI) which evaluated inflammation, exudate, and erythema; this project modifies that tool to include dehiscence. Other variables known to impact on wound healing including underlying medical conditions, nutrition, and smoking history will also be examined. Descriptive statistics and repeated measures analysis of variance will be used to report findings and determine the impact of chemotherapy on wound healing. This study will benefit nursing by objectively documenting information on the impact of 5-FU in wound healing. Additionally, it tests an objective method for clinical assessment of surgical wound healing, potentially contributing to earlier detection of altered wound states.