title: The use of autologous platelet and plasma products in salvage neck dissections: a prospective clinical study evaluating early and late wound healing.
abstract: OBJECTIVE
  To evaluate the effect of autologous platelet and plasma adhesives (APA) on postoperative drainage and soft-tissue fibrosis following neck dissections.
  
  
  METHODS
  This was a blinded comparative prospective cohort study done as two parts: part one evaluated early post-surgical outcomes and part two evaluated late tissue fibrosis.
  
  
  METHODS
  Salvage neck dissections were stratified into two groups based on severity of prior treatment. High risk patients were defined as those who had previously undergone chemoradiation therapy and autologous platelet adhesives were administered to the surgical wound intraoperatively. The low risk group consisted of patients undergoing salvage neck dissections following radiation only and acted as controls. Part one evaluated postsurgical wound drainage as the primary outcome as well as length of hospital stay and complications. Part two evaluated late postoperative tissue fibrosis by comparing neck skin using the Cutometer. R2 and F0 were the specific Cutometer parameters for quantifying the viscoelastic properties of the skin.
  
  
  RESULTS
  Postoperative wound drainage was significantly less (253.7 vs. 345.8) in the autologous platelet adhesive group as compared to the control group (p less than 0.03). Length of stay in the APA group versus the control group was 3.13 and 3.86 days respectively (p less than 0.004). Both R2 and F0 measurements showed improved viscoelastic properties of the skin in the APA group (R2 p less than 0.05, F0 p less than 0.05).
  
  
  CONCLUSIONS
  APA application following salvage neck dissections may reduce early postperative wound drainage and improve long-term skin quality.
authors: Department of Otolaryngology-Head and Neck Surgery, Western University, London, Ontario, Canada. john.yoo@lhsc.on.ca
authors: J
authors: J
authors: Yoo
authors: S
authors: S
authors: Chandarana
authors: K
authors: K
authors: Fung
authors: J H
authors: JH
authors: Franklin
authors: A C
authors: AC
authors: Nichols
authors: P C
authors: PC
authors: Doyle
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001792:Blood Platelets / Q000737:chemistry*; D004322:Drainage; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000737:chemistry / Q000302:isolation & purification / Q000494:pharmacology*; D005355:Fibrosis / Q000517:prevention & control; D005720:Gamma Rays; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000534:rehabilitation* / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D012867:Skin / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D000970:Antineoplastic Agents; D015718:Fibrin Tissue Adhesive