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MacFee incision: a safe approach to the neck

K White1, D M Mosdell, D Morris

  • 1Department of Surgery, Louisiana State University Medical Center, Shreveport.

Southern Medical Journal
|August 1, 1993
PubMed
Summary

The MacFee incision is a viable option for head and neck cancer surgery, comparable to other methods. While some malnourished patients experienced wound complications, they were manageable with conservative treatment.

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Area of Science:

  • Head and Neck Surgery
  • Surgical Oncology
  • Oral and Maxillofacial Surgery

Background:

  • Neck dissections are crucial for managing oral cavity and oropharyngeal neoplasms.
  • Cervical incisions are selected based on tumor location and extent.
  • Reconstruction techniques, such as myocutaneous flaps, are often necessary.

Purpose of the Study:

  • To evaluate the safety and efficacy of the MacFee incision versus the double horizontal cervical incision in head and neck cancer surgery.
  • To assess the incidence of wound complications and other morbidities associated with these incisions.
  • To compare operative morbidity between the two surgical approaches.

Main Methods:

  • Retrospective review of 37 neck dissections using MacFee or double horizontal cervical incisions.

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  • Analysis of patient demographics, tumor characteristics, and treatment modalities.
  • Evaluation of immediate reconstruction with myocutaneous flaps and preoperative radiotherapy.
  • Documentation of wound complications, carotid artery involvement, wound dehiscence, and deep cervical infections.

    • Main Results:

    • Three wound complications occurred in malnourished patients who underwent reconstruction with the MacFee incision; these were managed conservatively.
    • No instances of carotid artery involvement, wound dehiscence, or deep cervical infections were observed.
    • Approximately 70% of patients presented with advanced tumors and malnutrition.
    • Preoperative radiotherapy was identified as a contributing factor to morbidity.

    Conclusions:

    • The MacFee incision is a safe and effective approach for major head and neck resections.
    • Operative morbidity associated with the MacFee incision is comparable to alternative techniques.
    • Careful patient selection and management of malnutrition are important considerations for minimizing wound complications.