Arora Jagmeet S, Kim Joshua K, Pakvasa Mikhail, Sayadi Lohrasb R, Lem Melinda, Widgerow Alan D, Leis Amber R
From the School of Medicine, University of California Irvine, Orange, Calif.
University of California Irvine, Irvine, Calif.
Plast Reconstr Surg Glob Open. 2023 Aug 4;11(8):e5171. doi: 10.1097/GOX.0000000000005171. eCollection 2023 Aug.
Approximately 20% of retained foreign bodies are surgical needles. Retained macro-needles may become symptomatic, but the effect of microsurgical needles is uncertain. We present the first animal model to simulate microsurgical needle retention. Given a lack of reported adverse outcomes associated with macro-needles and a smaller cutting area of microsurgical needles, we hypothesized that microsurgical needles in rats would not cause changes in health or neurovascular compromise.
Male Sprague-Dawley rats (x̄ weight: 288.9 g) were implanted with a single, 9.0 needle (n 8) or 8.0 needle (n 8) orthogonal to the right femoral vessels and sutured in place. A control group (n 8) underwent sham surgery. Weekly, a cumulative health score evaluating body weight, body condition score, physical appearance, and behavior for each rat was determined. Infrared thermography (°C, FLIR one) of each hindlimb and the difference was obtained on postoperative days 15, 30, 60, and 90. On day 90, animals were euthanatized, hindlimbs were imaged via fluoroscopy, and needles were explanted.
The mean, cumulative health score for all cohorts at each weekly timepoint was 0. The mean temperature difference was not significantly different on postoperative days 15 ( = 0.54), 30 ( = 0.97), 60 ( = 0.29), or 90 ( = 0.09). In seven of eight rats, 8.0 needles were recovered and visualized on fluoroscopy. In six of eight rats, 9.0 needles were recovered, but 0/8 needles were visualized on fluoroscopy.
Microsurgical needle retention near neurovascular structures may be benign, and imaging for needles smaller than 8.0 may be futile. Further studies should explore microsurgical needle retention potentially through larger animal models.
约20%的残留异物是手术针。残留的大针可能会出现症状，但显微手术针的影响尚不确定。我们提出了第一个模拟显微手术针残留的动物模型。鉴于缺乏与大针相关的不良结局报告以及显微手术针较小的切割面积，我们假设大鼠体内的显微手术针不会导致健康变化或神经血管受损。
将雄性Sprague-Dawley大鼠（平均体重：288.9克）与右股血管正交植入一根9.0针（n = 8）或8.0针（n = 8）并缝合固定。对照组（n = 8）接受假手术。每周确定每个大鼠的累积健康评分，评估体重、身体状况评分、外观和行为。在术后第15、30、60和90天对每个后肢进行红外热成像（°C，FLIR one）并获取差值。在第90天，对动物实施安乐死，通过荧光透视对后肢成像，并取出针。
每个每周时间点所有队列的平均累积健康评分为0。术后第15天（P = 0.54）、30天（P = 0.97）、60天（P = 0.29）或90天（P = 0.09）的平均温差无显著差异。在8只大鼠中的7只中，回收了8.0针并在荧光透视下可见。在8只大鼠中的6只中，回收了9.0针，但荧光透视下0/8针可见。
神经血管结构附近的显微手术针残留可能是良性的，对小于8.0的针进行成像可能是徒劳的。进一步的研究应通过更大动物模型探索显微手术针残留情况。
