WOUND IRRIGATION IN CANCER SURGERY

The incidence of local recurrence of cancer following radical mastectomy for breast carcinoma and radical surgery for head and neck malignancy is higher than is generally realized. In most instances the cause of the recurrence appears to be implantation, or more descriptively, wound seeding. This is the most insidious type of cancer dissemination with which the surgeon is confronted. Mechanical flushing of the wound with physiologic saline or distilled water is not sufficient to prevent the occurrence of implantation. The possibility of wound implantation can be decreased somewhat by careful surgical technique including the frequent changing of gloves and instruments. However, these methods alone do not appear to be sufficient to protect the patient from being seeded with his own tumor. In the experimental laboratory we determined that a 2% solution of a form of monoxychlorosene (Clorpactin XCB) and a 2 mg. % mechlorethamine (nitrogen mustard) solution, properly diluted so that