Okuyama Kohei, Yanamoto Souichi, Naruse Tomofumi, Sakamoto Yuki, Rokutanda Satoshi, Ohba Seigo, Asahina Izumi, Umeda Masahiro
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Jun;125(6):541-546. doi: 10.1016/j.oooo.2017.12.013. Epub 2017 Dec 29.
Covering open wounds with a polyglycolic acid (PGA) sheet using fibrin glue after resection of oral mucosal lesions is reportedly useful. We focused on clinical complications of this procedure: development of marked granuloma-like neoplasm (GLN) and abnormal postoperative bleeding (APB) on the resected region.
The characteristics of 100 cases with PGA sheet application after the resection of oral mucosal lesion were examined retrospectively by the medical records and/or oral photographs at our department between 2010 and 2016.
Our retrospective analysis identified included 8 cases of GLN development and 7 cases of APB. There was a significantly higher risk of GLN development when the PGA sheet was applied to the raw surface of the tongue. There were no immediate APBs, but 4 APBs occurred several hours after surgery. All APB cases involved the tongue.
Both GLNs and APBs are minor complications. Although all cases of GLNs did not involve the recurrence of a tumor, follow-up with incisional or excisional biopsy should be performed. APB in the oral cavity induced by the PGA sheet peeling due to fluctuating adhesive force of the PGA sheets and fibrin glue can sometimes induce life-threatening events.
据报道,在切除口腔黏膜病变后使用纤维蛋白胶将聚乙醇酸(PGA)片覆盖于开放性伤口是有效的。我们关注该手术的临床并发症:在切除区域出现明显的肉芽肿样肿瘤(GLN)以及异常术后出血(APB)。
回顾性检查了2010年至2016年间在我科接受口腔黏膜病变切除术后应用PGA片的100例患者的病历和/或口腔照片,以了解其特点。
我们的回顾性分析发现了8例GLN病例和7例APB病例。当PGA片应用于舌的创面时,GLN发生的风险显著更高。没有立即发生的APB,但有4例APB在术后数小时出现。所有APB病例均涉及舌头。
GLN和APB均为轻微并发症。虽然所有GLN病例均未涉及肿瘤复发,但应进行切开或切除活检随访。由于PGA片和纤维蛋白胶的黏附力波动导致PGA片剥离引起的口腔APB有时可能引发危及生命的事件。