Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model

Background:. 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...

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Main Authors: Jagmeet S. Arora, BS, Joshua K. Kim, BS, Mikhail Pakvasa, MD, Lohrasb R. Sayadi, MD, Melinda Lem, MD, Alan D. Widgerow, MBBCh, MMed, Amber R. Leis, MD, FACS
Format: Article
Language:English
Published: Wolters Kluwer 2023-08-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005171
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author Jagmeet S. Arora, BS
Joshua K. Kim, BS
Mikhail Pakvasa, MD
Lohrasb R. Sayadi, MD
Melinda Lem, MD
Alan D. Widgerow, MBBCh, MMed
Amber R. Leis, MD, FACS
author_facet Jagmeet S. Arora, BS
Joshua K. Kim, BS
Mikhail Pakvasa, MD
Lohrasb R. Sayadi, MD
Melinda Lem, MD
Alan D. Widgerow, MBBCh, MMed
Amber R. Leis, MD, FACS
author_sort Jagmeet S. Arora, BS
collection DOAJ
description Background:. 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. Methods:. 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. Results:. 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 (P = 0.54), 30 (P = 0.97), 60 (P = 0.29), or 90 (P = 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. Conclusions:. 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.
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spelling doaj.art-0038e232a4bc4ecabd6991e97528b4052023-08-30T06:13:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-08-01118e517110.1097/GOX.0000000000005171202308000-00012Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat ModelJagmeet S. Arora, BS0Joshua K. Kim, BS1Mikhail Pakvasa, MD2Lohrasb R. Sayadi, MD3Melinda Lem, MD4Alan D. Widgerow, MBBCh, MMed5Amber R. Leis, MD, FACS6From the * School of Medicine, University of California Irvine, Orange, Calif.† University of California Irvine, Irvine, Calif.‡ Department of Plastic Surgery, University of California Irvine, Orange, Calif.‡ Department of Plastic Surgery, University of California Irvine, Orange, Calif.From the * School of Medicine, University of California Irvine, Orange, Calif.§ Center for Tissue Engineering, Department of Plastic Surgery, University of California Irvine, Orange, Calif.‡ Department of Plastic Surgery, University of California Irvine, Orange, Calif.Background:. 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. Methods:. 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. Results:. 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 (P = 0.54), 30 (P = 0.97), 60 (P = 0.29), or 90 (P = 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. Conclusions:. 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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005171
spellingShingle Jagmeet S. Arora, BS
Joshua K. Kim, BS
Mikhail Pakvasa, MD
Lohrasb R. Sayadi, MD
Melinda Lem, MD
Alan D. Widgerow, MBBCh, MMed
Amber R. Leis, MD, FACS
Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
Plastic and Reconstructive Surgery, Global Open
title Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
title_full Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
title_fullStr Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
title_full_unstemmed Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
title_short Microsurgical Needle Retention Does Not Cause Pain or Neurovascular Injury in a Rat Model
title_sort microsurgical needle retention does not cause pain or neurovascular injury in a rat model
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005171
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