Retardation of wound healing by procaine: Morris T, Appleby R, Br J Surg, 67:391–392, 1980
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Retardation of wound healing by procaine. Morris T, Appleby R, Br J Surg, 67:391-392, 1980. Recently the effect of local lidocaine infiltration on wound healing was studied and it was found to be inhibitory. The authors of this study used abdominal incisions on laboratory rats to determine whether procaine local anesthetic also re- tarded wound healing. The animals were divided into eight groups and varying concentrations of anesthetic were used, including sterile water, 0.5%, 1%, 2%, and 0.5% through 2% with 1:100,000 adrenaline. The eighth group were untreated controls. The rats were sacrificed at five and seven days, the sutures were removed, and the incisions were placed in a simple distraction apparatus. After five days of healing, the wounds that were injected (including sterile water) were sig- nificantly weaker than those in the untreated controls (P<0.005). However, there was no difference in wound heal- ing with 0.5% procaine and sterile water until greater con- centrations of procaine were used. The higher the concentra- tion, the greater the retardation of healing. The addition of adrenaline significantly retarded wound healing of 0.5% and 2% procaine concentration, but not the 1% concentration. By day seven, the only group in which there was significant re- tardation was the 2% + adrenaline group. The authors con- clude that 1% and 2% concentrations of procaine retard the healing of tissues. They suggest that the mechanism may be similar to lidocaine, ie, depressed synthesis of mucopolysac- charides and thus possibly collagen. (Editor's note" Wound healing was determined by testing bursting strengths of the excised wounds. Healing was retarded for seven days. The au- thors use this study to suggest skin stitches be left in at least seven days. If a good intradermal closure has been performed, this has not proved necessary on facial skin sutures which can safely be removed at three to flue days. It certainly doesn't hurt to replace the skin stitches with steristrips.) wounds, procaine John Tucker, MD Traumatic intracranial aneurysms. Parkinson D, West M, J Neurosurg 52:11-20, 1980. Eleven cases of post-traumatic intracranial aneurysm (six saccular, five arteriovenous, in patients with a mean age of 44.7 years) collected over an eight-year period are reviewed. Etiology was assault in five cases, and only two were sus- tained in automobile accidents. Clinical signs included de- pressed level of consciousness in 10, hemiparesis in six, oculo- motor palsy in four, and a variety of other neurological signs. Approximately two-thirds had an associated cerebral contu- sion and/or laceration, while slightly over one-half had in- tracranial hemorrhage. Of 10 patients having initial skull films, seven had demonstrable skull fractures. Angiography was performed for: 1) evolving coma; 2) delayed neurological deterioration; and 3) failure to improve after causes other than head injury were excluded. There were two post- operative deaths (22.2% mortality). It is suggested that all severely head-injured patients with any of the three aforementioned criteria be angiographically studied because CAT scan will frequently fail to show an aneurysm in the presence of an accompanying hematoma. (Editor's note" It would be interesting to know how common this problem is. It might be helpful to do contrast CAT scans. Perhaps those su- perficial lesions are the source of most intracranial traumatic bleeds.) Steve Cooley, MD aneurysm, intracranial Advertisers' Index American Critical Care Intropin ................................. 64-66 A stra Pharmaceuticals 4% Topical Solution ...................... 52,53 Brault Strauchman & Associates Management Services ........................ 96 Breon Laboratories, lnc Marcaine ................................. 82,83 Cutter Biomedical C-splint .................................... 4,5 Endo Laboratories Narcan .................................. 38-40 EPT Enterprises Professional Liability Insurance .............. 91 ER Reports Publication .................................. 6 Johnson & Johnson Adaptic .............................. Cover III Release ..................................... 76 Kendall Company Bandages and Dressings .................. 26,27 Knoll Pharmaceuticals Image ................................ Cover IV Laerdal ACLS Training Aids ......................... 8 3M Orthopedic Products Scotchcast ............................... 72,73 McNeil Consumer Products Tylenol ..................................... 12 McNeil Laboratories Tylenol With Codeine ..................... 34,35 Mead Johnson Duricef ..... ................................ 28 MedaSonics, Inc Model BF4A ................................ 34 Organon Pharmaceuticals Hexadrol ................................. 46,47 Physio-Control Corp Lifepak 5 ................................... 23 Primary Healthcare Enterprises ................. 66 Roerig Navane .................................. 57,58 Spectrum Emergency Group Employment Opportunities ................... 24 Stuart Pharmaceuticals Hibiclens .................................... 48 Syva Emit .................................... 74,75 University of California, San Diego Educational Program ........................ 11 Wallace Laboratories .................. Cover II, 1,2 Winthrop Laboratories Talwin Oral "50" . ........................ 24,25 8B/284 Ann Emerg Med 10:5 (May) 1981
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Transcript of Retardation of wound healing by procaine: Morris T, Appleby R, Br J Surg, 67:391–392, 1980
Retardation of wound healing by procaine. Morris T, Appleby R, Br J Surg, 67:391-392, 1980.
Recently the effect of local lidocaine infiltration on wound healing was studied and it was found to be inhibitory. The authors of this study used abdominal incisions on laboratory rats to determine whether procaine local anesthetic also re- tarded wound healing. The animals were divided into eight groups and varying concentrations of anesthetic were used, including sterile water, 0.5%, 1%, 2%, and 0.5% through 2% with 1:100,000 adrenaline. The eighth group were untreated controls. The rats were sacrificed at five and seven days, the sutures were removed, and the incisions were placed in a simple distraction apparatus. After five days of healing, the wounds that were injected (including sterile water) were sig- nif icant ly weaker than those in the un t rea ted controls (P<0.005). However, there was no difference in wound heal- ing with 0.5% procaine and sterile water until greater con- centrations of procaine were used. The higher the concentra- tion, the greater the retardation of healing. The addition of adrenaline significantly retarded wound healing of 0.5% and 2% procaine concentration, but not the 1% concentration. By day seven, the only group in which there was significant re- tardation was the 2% + adrenaline group. The authors con- clude that 1% and 2% concentrations of procaine retard the healing of tissues. They suggest that the mechanism may be similar to lidocaine, ie, depressed synthesis of mucopolysac- charides and thus possibly collagen. (Ed i tor ' s note" Wound healing was determined by testing bursting strengths of the excised wounds. Healing was retarded for seven days. The au- thors use this study to suggest skin stitches be left in at least seven days. I f a good intradermal closure has been performed, this has not proved necessary on facial skin sutures which can safely be removed at three to flue days. I t certainly doesn't hurt
to replace the skin stitches with steristrips.)
wounds, procaine John Tucker, MD
Traumatic intracranial aneurysms. Parkinson D, West M, J Neurosurg 52:11-20, 1980.
Eleven cases of post-traumatic intracranial aneurysm (six saccular, five arteriovenous, in patients with a mean age of 44.7 years) collected over an eight-year period are reviewed. Etiology was assault in five cases, and only two were sus- tained in automobile accidents. Clinical signs included de- pressed level of consciousness in 10, hemiparesis in six, oculo- motor palsy in four, and a variety of other neurological signs. Approximately two-thirds had an associated cerebral contu- sion and/or laceration, while slightly over one-half had in- tracranial hemorrhage. Of 10 patients having initial skull films, seven had demonstrable skull fractures. Angiography was performed for: 1) evolving coma; 2) delayed neurological deterioration; and 3) failure to improve after causes other than head injury were excluded. There were two post- operative deaths (22.2% mortality). It is suggested that all s eve re ly head - in ju red pa t i en t s wi th any of the th ree aforementioned criteria be angiographically studied because CAT scan will frequently fail to show an aneurysm in the presence of an accompanying hematoma. (Ed i tor ' s note" It would be interesting to know how common this problem is. It might be helpful to do contrast C A T scans. Perhaps those su- perficial lesions are the source of most intracranial traumatic bleeds.)
Steve Cooley, MD
aneurysm, intracranial
Advertisers' Index A m e r i c a n Cr i t ica l Care
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A s t ra P h a r m a c e u t i c a l s 4% Topical S o l u t i o n . . . . . . . . . . . . . . . . . . . . . . 52,53
Brau l t S t r a u c h m a n & Assoc ia tes M a n a g e m e n t Serv i ce s . . . . . . . . . . . . . . . . . . . . . . . . 96
Breon Labora tor ies , lnc M a r c a i n e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82,83
Cu t t e r Biomedica l C-sp l in t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,5
Endo Labora to r i e s N a r c a n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 -40
EPT En te rp r i s e s P r o f e s s i o n a l L i a b i l i t y I n s u r a n c e . . . . . . . . . . . . . . 91
ER Repor ts P u b l i c a t i o n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Johnson & J o h n s o n A d a p t i c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cover III Re lease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76
Kenda l l C o m p a n y B a n d a g e s a n d D r e s s i n g s . . . . . . . . . . . . . . . . . . 26,27
Knol l P h a r m a c e u t i c a l s I m a g e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cover IV
Laerda l A C L S T r a i n i n g A i d s . . . . . . . . . . . . . . . . . . . . . . . . . 8
3M Orthopedic Produc t s Sco tchcas t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72,73
McNei l C o n s u m e r Products Tylenol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
McNei l Labora to r i e s Tylenol W i t h Code ine . . . . . . . . . . . . . . . . . . . . . 34,35
Mead J o h n s o n D u r i c e f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
MedaSonics , Inc M o d e l B F 4 A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Organon P h a r m a c e u t i c a l s H e x a d r o l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46,47
Phys io-Cont ro l Corp L i f e p a k 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
P r i m a r y H e a l t h c a r e E n t e r p r i s e s . . . . . . . . . . . . . . . . . 66
Roer ig N a v a n e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57,58
S p e c t r u m E m e r g e n c y Group E m p l o y m e n t O p p o r t u n i t i e s . . . . . . . . . . . . . . . . . . . 24
S t u a r t P h a r m a c e u t i c a l s H i b i c l e n s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Syva E m i t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74,75
U n i v e r s i t y of Cal i forn ia , San Diego E d u c a t i o n a l P r o g r a m . . . . . . . . . . . . . . . . . . . . . . . . 11
Wal lace Labora to r i e s . . . . . . . . . . . . . . . . . . Cover II, 1,2
W i n t h r o p Labora to r i e s T a l w i n Ora l "50" . . . . . . . . . . . . . . . . . . . . . . . . . 24,25
8B/284 Ann Emerg Med 10:5 (May) 1981
