Shlomo Teicher | PubMed Health

PubMed2003

Amputation neuromas after neck dissection.

OBJECTIVE: We sought to define the incidence of neuroma formation after neck dissection in a large series of patients. METHODS: One hundred fifty-three patients who were seen during a 2-year period (followed for 3 months to 10 years; mean, 52 months) were evaluated for neuroma formation after neck dissection (185 procedures). Cut nerve edges were not routinely ligated or cauterized. RESULTS: Operative records indicated that except for 4 cases, the stumps of the great auricular nerve and cervical branches were left intact after resection. No cases of palpable neuromas were found. In one case of a revised neck, a small macroscopically indiscernible nodule was histologically defined as neuroma. CONCLUSION: No neuromas were discovered in our series of neck dissection cases. If found, it is imperative these lesions be differentiated from recurrent cancer. Our results do not support any interference with cut nerve edges.

Adult↗

PubMed2002

The effect of bacterial endotoxin on the early tensile strength of healing surgical wounds.

Wound healing in the oral cavity occurs in a bacteria-rich environment, which may affect its outcome. Furthermore, it takes place where forces are frequently applied to the healing tissue. The effect of bacterial endotoxin on the development of tensile strength in healing wounds was studied using surgical skin wounds in rats as a model. Collagen membranes soaked with 0.01 microg of bacterial endotoxin were inserted into surgical skin wounds, and their effect was studied on days 6 and 10. Membranes with no endotoxin served as controls. Endotoxin inhibited the early development of tensile strength in 6 days, healing wounds by 38%, whereas the collagen membrane alone had no effect. Dexamethasone (0.5 mg/kg every 72 h) had a suppressive effect on the development of tensile strength in healing noncontaminated wounds, but not in those containing bacterial endotoxin. These results suggest that bacterial endotoxin may interfere with the early healing of wounds. Understanding the mechanisms of this inhibition may result in treatments that will allow this response to be faster and more reproducible.

Analysis of Variance↗