Expression of wound healing related histochemical and immunohistochemical stains at the time of salvage isolated neck dissection - an exploratory study

IntroductionSalvage surgery is known for an increased surgical complication rate. However, currently available patient, tumor and therapy factors are not reliable enough to predict surgical site complications (SSC). This exploratory study tests skin acquired by neck dissection for several histochemical and immunohistochemical stains to explore tissue changes related to wound healing. Patients and methodsFrom an existing database of 232 isolated neck dissections (ND), seventeen patients with skin resection during ND were included - five primary and twelve salvage procedures. Skin specimens were tested for ten histochemical and immunohistochemical stains, with emphasis on the stages of wound healing; inflammation, proliferation and remodeling. ResultsThree stains (CD-68, -SMA, and Vimentin), showed significant different expressions between the primary surgical and salvage groups (respectively p = 0.013, p = 0.044 and p = 0.015), without a clear pattern of decreased or increased expression. None of the ten stains showed a significant difference related to SSC. ConclusionThe three significantly different staining patterns found in this exploratory study all are related to macrophage and (myo-)fibroblast transition, possibly representing an imbalance of macrophage/stroma interplay. Future studies should focus on the pivotal role of macrophages in wound healing after salvage surgery.