Clinical Experience Using a Combination of PGA Sheet and Spraying of Fibrin Glue to Cover Partial Resection of Buccal Mucosa Carcinoma

Yasuniori Sato DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Sho Sato DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Shuri Hada DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Junko Nakajima DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Hidetaka Yokoe DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Hiroshi, Nozawa DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Shumei Yoshikawa DDS, PhD, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Ichiro Shoji DDS, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Jun Kinoda DDS, Oral and Maxillofacial Surgery, National Defense Medical College, Tokorozawa, Japan
Introduction

 In the cases of partial resection of soft tissue of oral cancer such as buccal mucosa cancer etc. reduced suture, free skin grafting, DP flap and forearm flap have been mainly selected for reconstruction considering the postoperative quolity of life(QOL). Currently a combination of polyglycolic acid sheet (PGA) and spraying of fibrin glue is tried to use for repair after resection of oral tumors. We report a case in which this method was used to cover part of the cut surface after resection of buccal mucosa carcinoma.

Subject and methods

 A 59-year-old man was admitted to our department with a chief complaint of tumor in the left buccal mucosa in 2013. A 16×10 mm tumor with ulcer was found in the region. The clinical diagnosis was buccal mucosa carcinoma and the lesion was excised under general anesthesia.

 A combination of PGA sheet and spraying of fibrin glue was used to cover the cut surface after resection of buccal mucosa lesion. Baccul fat was exposed at the cut surface and PGA sheet was placed on the buccal fat. Histopathologic diagnosis was squamous cell carcinoma of buccal mucosa.The prognosis is good after operation until now. 

Results

 Postoperative wound contraction of the scar is slight and the wound is covered with normal mucosa using a combination of PGA sheet and spraying of fibrin glue.

Discussion

 Technique of using a combination of PGA sheet and spraying of fibrin glue was as follow.

 We used a fibrin glue(The Bolheal,Teijin, Osaka, Japan) composed of fluid A, a fibrinogen preparation, and fluid B, a thrombin preparation. The two atomized fluids of fibrinogen preparation and thrombin preparation adhere firmly to the wound equally fast. The composition, when mixed at the site, undergoes instant fibrinogenesis with immediate tissue adhesion. The PGA sheet we used was NeoveilR(Gunze, Kyoto, Japan).

 The progress of the patient is good and there were no adverse events or side effects of this method.

Conclusions

 This method of a combination of PGA sheet and spraying of fibrin glue is considered to be useful for maintaining QOL of the patients after partial resection of baccul mucosa depending on the extent of tumor resection without using another reconstruction methods.

References

1)Sato Y.,et al. :Clinical Experience Using A Combination of PGA Sheet and Spraying of Fibrin Glue to Cover Partial Resection of Tongue Carcinoma. Hosp. Dent.(Tokyo) 22:203-206, 2010.12

2) Shinya,N., et al.:Improvement of the tissue-adhesive and sealing effect of fibrin sealant using polyglycolic acid felt. J Investig Surg, 22:383-389, 2009.

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