AB207. 159. An unusual clustered series of foreign body reactions to oxidized regenerated cellulose in head and neck surgery

Background: Oxidized regenerated cellulose (ORC) is a widely used hemostatic agent. Generally, its benefits in promoting clot formation outweigh its risks. Just two case reports exist reporting complications in head and neck patients. Herein we report a recent case series of three patients who experienced serious ORC related complications within a month of each other.

Methods: Our first patient a 36-year-old female day 2 post submandibular gland excision presented with airway compromise when rushed to theatre she was found to have a large mass of ORC and clot causing a local reaction. Our second case, a 56-year-old male day 4 post thyroglossal cyst excision, presented to the ED with what appeared to be post op abscess formation. Surgical exploration revealed copious amounts of infected ORC. Our final case is that of a 56-year-old female, day 2 post parotidectomy with increasing pain and fluctuance over the wound site secondary to an inflammatory reaction related to the se of ORC intra-operatively. On discussion with the consultants involved along with senior theatre staff it was found that a recent change in procurement resulted in the change in theatre.

Results: Although limited to case-reports morbidity related to ORC use can be devastating. This is the only case-report of a patient who necessitated emergent return to theatre secondary to life-threatening airway compromise.

Conclusions: Topical absorbable hemostats used in surgery should always be considered in the differential diagnosis of post-op complications.

Keywords: Hemostat; head and neck surgery; hypersensitivity