Azami Hassani Fatema Ez-Zahrae, Slimani Faiçal
Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, B.P 5696, Casablanca, Morocco.
Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, B.P 2698, Casablanca, Morocco.
Ann Med Surg (Lond). 2021 Feb 23;63:102187. doi: 10.1016/j.amsu.2021.102187. eCollection 2021 Mar.
The hemostatic agents have increased the bleeding complication in many surgeries. The SURGICEL is a preparation of oxidized cellulose regenerated from alpha-cellulose in an organic solvent, this product has the characteristic of resorbing without having a reaction of foreign body in 4-8 weeks.
We report the case of a patient operated on for a chondrosarcoma of the right temporomandibular joint with normal postoperative consequences, nevertheless after 3 months, the patient consulted again for the same symptomatology. To rule out tumor recurrence, magnetic resonance imaging has been requested; which showed a lesion well limited in T1 hypointense and heterogeneous in T2. During the surgical revision, we discover the presence of a reworked fibrous material, this material was the surgicel used for hemostatic purposes during the first surgery.
Hemostatic agents significantly reduced bleeding complications. But some authors are observed that some substances can persisted after 8 weeks of using, clinical manifestations depend of operative site. The diagnosis is suspected behind an imaging resonance aspect of a lesion well limited in T1 hypointense and heterogeneous in T2, but the discovery of a reworked fibrous materiel when the revision can confirm it.
the absence of degradation of the surgicel can clinically mimic a superinfection or even tumor recurrence; imaging guide the diagnosis but only the surgical revision can confirm it.
止血剂在许多手术中增加了出血并发症。SURGICEL是一种在有机溶剂中由α-纤维素再生的氧化纤维素制剂,该产品具有在4-8周内吸收且无异物反应的特性。
我们报告一例患者,因右颞下颌关节软骨肉瘤接受手术,术后情况正常,但3个月后,患者因相同症状再次就诊。为排除肿瘤复发,进行了磁共振成像检查;结果显示在T1加权像上为低信号且界限清晰、在T2加权像上不均匀的病变。在手术翻修过程中,我们发现存在一种经过处理的纤维材料,该材料是首次手术中用于止血目的的SURGICEL。
止血剂显著减少了出血并发症。但一些作者观察到,某些物质在使用8周后仍可残留,临床表现取决于手术部位。在T1加权像上界限清晰且为低信号、在T2加权像上不均匀的病变的磁共振成像表现可疑为某种情况,但在翻修手术中发现经过处理的纤维材料时可确诊。
SURGICEL未降解在临床上可能类似超级感染甚至肿瘤复发;影像学可指导诊断,但只有手术翻修才能确诊。