The impact of tissue glue in wound healing of head and neck patients undergoing neck dissection

Abstract

We investigated the impact of fibrin glue on postoperative drainage amount and duration in head and neck cancer patients who underwent neck dissection. This study was a prospective randomized controlled trial. Patients who were scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. After receiving a detailed explanation, all patients signed an informed consent form before enrollment. Patients were then randomly assigned to the study group (fibrin glue) or control group. In the study group, 2 ml of fibrin glue (Tissucol(®); Duploject, Baxter AG) was applied on the surface of the surgical wound before closure. Basic demographic data along with tumor-related features, operation-related variables, postoperative drainage amount/duration, postoperative pain, and analgesic usage were collected and analyzed. A total of 15 patients were included in the final analyses, with eight patients in the study group and seven patients in the control group. No significant differences were found between the two groups in age, gender, primary site, clinical N stage, neck dissection levels, perioperative bleeding, postoperative drainage amount/duration, hospitalization duration, and postoperative pain status. The application of 2 ml fibrin glue by the method described herein did not reduce the postoperative drainage amount/duration nor the postoperative pain status in patients who underwent neck dissection.

Fibrin sealants in soft tissue surgery of the head and neck: A systematic review and meta‐analysis of randomised controlled trials

“…included patients having central neck dissection, whereas Vidal‐Perez et al . included patients having central and lateral neck dissections), one at lateral neck dissection, one at parotidectomy and five at rhytidectomy . Only six of the included studies reported a sample size calculation and only three of these reached the planned sample size.…”

“…None of the five trials in which patients dropped out after randomisation performed an “intention‐to‐treat” analysis. They were considered at high risk of attrition bias if the number of dropouts were unequal between the two groups of patients . Four trials pre‐registered their protocol on ClinicalTrials.gov so that a comparison between the planned outcomes and reported outcomes could be made and assessment of reporting bias possible .…”

“…Postoperative pain was reported in three studies that found no significant difference between FS and control . All studies reported pain using visual analogue scales (VAS); only Vidal‐Perez et al.…”

“…No trials assessed if FS improved the recovery of function using patient‐reported outcome measures. In terms of FS being acceptable to patients, only the trial by Huang et al . reported difficulties in recruitment.…”

“…This heterogeneity can be explained by the fact that the three studies included in this analysis incorporated different surgical procedures. Huang et al just looked at lateral neck dissection, Kim et al just looked at total thyroidectomy with central neck dissection and Vidal‐Perez et al looked at total thyroidectomy with central and lateral neck dissection. The degree of heterogeneity is compounded by the fact that Vidal‐Perez et al showed a significantly greater benefit of using FS compared to the other studies.…”