Transplantation of tumor by suture thread and its prevention.An experimental study

Abstract

OCAL RECURRENCE following operative pro-L cedures for cancer has been a distressing problem for many years.There are many reports in the literature concerning the transplantation and implantation of inalignant cells during operative procedures.This report reviews the literature on some of the clinical problems involved in the spread of cancer.It will show that part of this dissemination can be caused by contamination of and subsequent implantation of cancer cells by suture material.A laboratory model is described that allows reproduction of this type of dissemination and measurement of the effectiveness of chemically treated sutures in the prevention of suture implants.In the latter part of the nineteenth and the early part of this century, surgeons debated the question of whether cancer found in the area of operation represented recurrence due to inadequate excision of the primaiy growth, a new primary cancer, or recurrence from implantation of cancer cells deposited in the wound at the time of the first operation.As early as 1885, Gerster25 wrote on the subject of mechanical dissemination of cancer during surgery as a cause of local recurrences.Lack,86 in 1896, called attention to the possibility of dissemination of cancer by direct transplantation and "infecting" a wound with "cancerous material."He cited several cases substantiating this possibility and suggested that the recurrent cancer was the result of contamination of instruments, sponges, or hands with cancer cells.Lawrie,87 in 1906, reported a case of a cancerous nodule occurring in the From the Surgery Branch, National Canter Institute, of the National Institutes of Health, Public Health Service, Bethesda, Md.The reaFnts tested for antitumor activity included the followng: p i d c acid (available from Merck &