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Comparing tissue coring potentials of hollow needles without stylet and caudal needles with stylet: an experimental study

Published online by Cambridge University Press:  01 June 2008

F. Guldogus
Affiliation:
Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology, Kurupelit, Samsun, Turkey
Y. S. Baris
Affiliation:
Ondokuz Mayıs University, Faculty of Medicine, Department of Pathology, Kurupelit, Samsun, Turkey
S. Baris*
Affiliation:
Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology, Kurupelit, Samsun, Turkey
D. Karakaya
Affiliation:
Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology, Kurupelit, Samsun, Turkey
E. Kelsaka
Affiliation:
Ondokuz Mayıs University, Faculty of Medicine, Department of Anesthesiology, Kurupelit, Samsun, Turkey
*
Anesteziyoloji ve Reanimasyon Anabilim Dalı, Tıp Fakültesi, Ondokuz Mayıs Üniversitesi, 55139, Kurupelit, Samsun, Turkey. E-mail: [email protected]; Tel: +90 362 4590272; Fax: +90 362 4576041
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Summary

Background and objectives

Although the association of tissue coring and development of epidermoid tumour has been proposed, the extent and frequency of such coring is still controversial and the viability of carried cells has not been substantiated. In the present study, we used an experimental model without needle removal to investigate the incidence of tissue coring using two different needle types.

Methods

We inserted 22-G caudal (n = 34) or 22-G hollow (n = 25) needles to the tumour-free areas of fresh modified mastectomy specimens. The specimen was stretched and needles were inserted perpendicular to the skin and forced to penetrate the full thickness of the specimen. Without removing the needle, the needle cavity was then washed with 2 mL of RPMI 1640 with l-Glutamine and the washings were collected in a 15-mL falcon tube. The tubes were sealed and labelled and processed to obtain cytologic preparations. The slides were evaluated under a light microscope.

Results

A high rate of epithelial cell transportation was noted. All the carried cells were stratum corneum cells with no nucleus. No nucleated cells were seen. The incidence of carried cells was 64.7% and 72.0% in the caudal and hollow needle groups, respectively (P > 0.05).

Conclusion

Only cells from the outermost layer, stratum corneum, which is made of dead flat skin cells, were transported with needle puncture. The risk of epidermoid tumour development after regional anaesthesia must therefore be low. The incidence of transporting non-nucleated stratum corneum cells was similar between hollow and caudal needles.

Type
Original Article
Copyright
Copyright © European Society of Anaesthesiology 2008

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References

1.Jeong, I-H, Lee, J-K, Moon, K-S et al. Iatrogenic intraspinal epidermoid tumor: case report. Pediatr Neurosurg 2006; 42: 395398.CrossRefGoogle ScholarPubMed
2.Goldschneider, KR, Brandom, BW. The incidence of tissue coring during the performance of caudal injection in children. Reg Anesth Pain Med 1999; 24: 553556.Google ScholarPubMed
3.Campbell, DC, Douglas, MJ, Taylor, GT. Incidence of tissue coring with the 25-gauge Quincke and Whitacre spinal needles. Reg Anesth 1996; 21: 582585.Google Scholar
4.Gardner, DJ, O’Gorman, AM, Blundell, JE. Intraspinal epidermoid tumour: late complication of lumbar puncture. Can Med Assoc J 1989; 141: 223225.Google ScholarPubMed
5.Halcrow, SJ, Crawford, PJ, Craft, AW. Epidermoid spinal cord tumour after lumbar puncture. Arch Dis Child 1985; 60: 978979.Google Scholar
6.Baris, S, Guldogus, F, Baris, YS, Karakaya, D, Kelsaka, E. Is tissue coring a real problem after caudal injection in children. Paediatr Anaesth 2004; 14: 755758.Google Scholar
7.Gibson, T, Norris, W. Skin fragments removed by injection needles. Lancet 1958; 2: 983985.Google Scholar
8.Murphy, GF. Histology of the skin. In: Elder, D, Elenitsas, R, Jaworsky, C, Johnson, B, eds. Lever’s Histopathology of the Skin, 8th edn. Philadelphia: Lippincott-Raven, 1997: 550.Google Scholar
9.Tunali, Y, Kaya, G, Tunali, G, Solakoglu, S, Yenice, S, Bahar, M. Detection of epithelial cell transfer in spinal areas by light microscopy and determining any tissue coring via cell culture during combined spinal-epidural interventions. Reg Anesth Pain Med 2006; 31: 539545.Google Scholar
10.Puolakka, R, Andersson, LC, Rosenberg, PH. Microscopic analysis of three different spinal needle tips after experimental subarachnoid puncture. Reg Anesth Pain Med 2000; 25: 163169.CrossRefGoogle ScholarPubMed