The Expression of Wound-Healing-Related Histochemical and Immunohistochemical Stains at the Time of Salvage Isolated Neck Dissection-An Exploratory Study.

Introduction: Salvage 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 (SSCs). 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 methods: From an existing database of 232 isolated neck dissections (NDs), 17 patients who underwent skin resection during ND were included-5 who underwent primary procedures and 12 who underwent salvage procedures. Skin specimens were tested for ten histochemical and immunohistochemical stains, with emphasis on the stages of wound healing: inflammation, proliferation and remodeling. Results: Three stains (CD-68, α-SMA, and Vimentin) showed significantly different expression 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 SSCs. Conclusions: The three significantly different staining patterns found in this exploratory study can all be linked to macrophage and (myo-)fibroblast transitions, possibly representing an imbalance of macrophage/stroma interplay. Future studies focusing on the role of macrophages in wound healing after salvage surgery are necessary.