Human Oral Mucosal Stem Cells Reduce Anastomotic Leak in an Animal Model of Colonic Surgery.

BACKGROUND: Anastomotic leak is regarded as one of the most feared complications of bowel surgery; avoiding leaks is a major priority. Attempts to reduce or eliminate leaks have included alternate anastomotic techniques. Human oral mucosa stem cells (hOMSC) are self-renewing and expandable cells derived from buccal mucosa. Studies have shown that hOMSC can accelerate tissue regeneration and wound healing. The objective of this study was to evaluate whether hOMSC can decrease anastomotic leak rates in a murine model of colon surgery. METHODS: Two experiments were performed. In the first study, mice underwent colonic anastomosis using five interrupted sutures. hOMSC (n = 7) or normal saline (NS; n = 17) was injected into the colon wall at the site of the anastomosis. To evaluate whether hOMSC can impact anastomotic healing, the model was stressed by repeating the first experiment, reducing the number of sutures used for the construction of the anastomosis from five to four. Either hOMSC (n = 8) or NS (n = 20) was injected at the anastomosis. All mice that survived were sacrificed on postoperative day 7. Anastomotic leak rate, mortality, daily weight, and daily wellness scores were compared. RESULTS: In the five-suture anastomosis, there were no differences in anastomotic leak rate, mortality, or daily weight. Mice that received hOMSC had significantly higher wellness scores on postoperative day 2 (p < 0.05). In the four-suture anastomosis, there was a significant decrease in leak rate (70% [NS] vs. 25% [hOMSC], p = 0.029) and higher wellness scores in mice that received hOMSC (p < 0.05). CONCLUSION: Our study suggests that injecting hOMSC at the colonic anastomosis can potentially reduce anastomotic leak and improve postoperative wellness in a murine model of colon surgery.

Oral myopericytoma: a rare pediatric case report and a review of the literature.

BACKGROUND: Myopericytoma is a rare mesenchymal neoplasm with perivascular myoid differentiation that arises most commonly in middle adulthood. The lesion generally involves the subcutaneous tissue of distal extremities. Myopericytoma of the oral cavity is extremely rare. Herein we report a case of oral myopericytoma in a pediatric patient, who was treated via a conservative approach with a follow up of 8 years. The case is followed by a literature review. To our knowledge this is the first documented case of oral myopericytoma affecting a patient of such a young age. CASE PRESENTATION: A 6 years old boy was referred to the maxillofacial surgery department for the evaluation of a solitary growth of the right maxillary buccal and palatal gingiva. Histology and immunohistochemistry confirmed the diagnosis of myopericytoma. CONCLUSIONS: Our patient was treated by local excision with no recurrence in 8 years of follow up. Conservative approach should be considered for the treatment oral myopericytoma especially in young patients in tooth bearing areas.

The efficiency of extended postoperative antibiotic prophylaxis in orthognathic surgery: A prospective, randomized, double-blind, placebo-controlled clinical trial.

Postoperative antibiotics are commonly administered in orthognathic surgery, despite the fact that there is no consensus regarding their efficacy. The objective of this study was to investigate the effectiveness of postoperative antibiotics in orthognathic surgery by conducting a prospective, randomized, double-blind, placebo-controlled trial. Patients were randomly allocated into one of two study groups: the intervention group (treated with 1 g of intravenous (IV) amoxicillin-clavulanate TID) or the placebo group (treated with 50 mL of IV 0.9% NaCl TID). The infection rate was assessed using clinical and laboratory parameters. The intervention group included 38 patients, with 40 patients in the placebo group. Baseline and surgical characteristics were comparable between both groups. Mean postoperative C-reactive protein (CRP) and temperature were similar for both groups. Serous discharge was observed in two patients (both in the placebo group), and one of them required surgical intervention. Overall, infection rate was similar in both groups (p-value > 0.1). To conclude, administration of postoperative antibiotics in healthy, young patients undergoing orthognathic surgery did not show a significant advantage in reducing surgical infection rate.