Effectiveness of the Fibrinogen-Thrombin-Impregnated Collagen Patch in the Prevention of Postoperative Complications after Parotidectomy: A Single-Blinded, Randomized Controlled Study

• Type of Material: Article
• Authors: Kunho Song, Chungnam National University; Chan Oh, Chungnam National University; Ho-Ryun Won, Chungnam National University; Bon Seok Koo, Chungnam National University; Da Mi Kim, Chungnam National University; Min-Kyung Yeo, Chungnam National University; Yujin Choi, Emory University; Jae Won Chang, Emory University
• Language: English
• Date: 2022-02-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/jcm11030746
• Title of Journal or Parent Work: JOURNAL OF CLINICAL MEDICINE
• Volume: 11
• Issue: 3
• Grant/Funding Information: This research was funded by the Chungnam National University Hospital Research Fund (grant number 2018-CF-031), the National Research Foundation of Korea (NRF) funded by the Korean government (MEST) (grant number 2016R1D1A1B04932112 and 2021R1C1C1014142).
• Keywords: parotidectomy; INCISION; Life Sciences & Biomedicine; facial asymmetry; FREY-SYNDROME; parotid tumor; EFFICACY; DERMOFAT GRAFT; postoperative drain; SUPERFICIAL PAROTIDECTOMY; Frey's syndrome; Science & Technology; MORBIDITY; STERNOCLEIDOMASTOID MUSCLE FLAP; General & Internal Medicine; Medicine, General & Internal; SURGERY; MUSCULOAPONEUROTIC SYSTEM PLICATION; TACHOSIL; fibrinogen-thrombin-collagen sponge patch
• Research Categories: Health Sciences, Radiology; Health Sciences, Pathology; Health Sciences, Medicine and Surgery

Abstract

We investigated whether a fibrinogen-thrombin collagen sponge patch reduces postoperative complications of parotid gland surgery. This single-blinded, randomized controlled study included 165 patients who underwent parotid surgery for benign tumors (2018–2019) at a tertiary center. Primary outcomes were postoperative drain amount, days until drain removal, and discharge. Patients were scheduled for follow-up at 1 and 4 weeks, and 3 months after surgery. Complications including surgical site infection, pain, seroma, sialocele, salivary fistula, facial nerve palsy, Frey’s syndrome with subjective symptoms, and facial asymmetry were analyzed. After identifying confounding variables, multivariate approaches were used. Histologic analysis was performed in a mouse model of salivary gland surgery. In total, 162 patients (77, fibrinogen-thrombin collagen patch group; 85, controls) were included, with no significant between-group differences other than resected tissue. Among postoperative total drain amount and days until drain removal and discharge, the only postoperative total drain was significantly lower in the patch group than in the control group in the adjusted model. Additionally, although validation through robust trials with longer follow-up is needed, we found the potential benefit of the fibrinogen patch on Frey’s syndrome and facial asymmetry. In conclusion, fibrinogen-thrombin-impregnated collagen patches in parotidectomy can reduce postoperative drainage and improve outcomes.