Literature DB >> 16984891

Clean-contaminated neck surgery: risk of infection by intrinsic and extrinsic factors.

Massimo Fusconi1, Andrea Gallo, Cecilia Vitiello, Giulio Pagliuca, Gianna Pulice, Marco de Vincentiis.   

Abstract

OBJECTIVE: To evaluate the risk of surgical wound infection (the most common complication in neoplastic clean-contaminated neck surgery) due to 10 intrinsic risk factors and 5 extrinsic risk factors.
DESIGN: Retrospective clinical study.
SETTING: Academic tertiary referral medical center. PATIENTS: The study group included 115 patients with laryngeal carcinomas referred to our department from January 1, 1996, to August 31, 2002. INTERVENTION: Fifty-seven patients underwent total laryngectomy and 58 underwent subtotal laryngectomy. MAIN OUTCOME MEASURES: The association between surgical wound infection due to 10 intrinsic risk factors and 5 extrinsic risk factors was evaluated with multivariate models.
RESULTS: Surgical wound infection occurred in 27 patients (23.5%). There was no significant increase in the incidence of infection in patients with extensive tumors (P>.20) and in patients undergoing total laryngectomy and subtotal laryngectomy (P>.20). The incidence of infection was significantly higher in patients with stage IV disease (P<.01), in patients who underwent neck dissections (P<.05), and in those presenting with lymph node metastases (P<.001). Multivariate analysis showed that the presence of higher tumor stage is the best predictor of infection because it is the only significant factor (P<.03) even when adjusting for others. The association between infection and the other factors considered in this study (age [P>1.0], underweight [P = .26], anemia [P = .84], lymphocytopenia [P = .79 by Fisher exact test], number of preoperative hospitalizations [P<1.0], preoperative radiotherapy [P = .57 by Fisher exact test], diabetes mellitus [P = .70 by Fisher exact test], cirrhosis, resection margins infiltrated by the tumor [P = .57 by Fisher exact test], and myocutaneous flap reconstructions [P = .82]) was not significant.
CONCLUSION: The risk of surgical wound infection is correlated with a higher tumor stage and lymph node metastases; it is not associated with the extent of surgery or other factors considered.

Entities:  

Mesh:

Year:  2006        PMID: 16984891     DOI: 10.1001/archotol.132.9.953

Source DB:  PubMed          Journal:  Arch Otolaryngol Head Neck Surg        ISSN: 0886-4470


  5 in total

1.  Postoperative antibiotic prophylaxis in clean-contaminated head and neck oncologic surgery: a retrospective cohort study.

Authors:  C-J Busch; R Knecht; A Münscher; J Matern; C Dalchow; B B Lörincz
Journal:  Eur Arch Otorhinolaryngol       Date:  2015-12-18       Impact factor: 2.503

2.  Risk factors for surgical site infection in head and neck cancer.

Authors:  Chengwen Gan; Yannan Wang; Yan Tang; Kai Wang; Bincan Sun; Mengxue Wang; Feiya Zhu
Journal:  Support Care Cancer       Date:  2021-11-26       Impact factor: 3.603

3.  Pharyngocutaneous fistula: the incidence and the risk factors.

Authors:  Robert Šifrer; Aleksandar Aničin; Maja Perme Pohar; Miha Žargi; Peter Pukl; Tanja Soklič; Primož Strojan
Journal:  Eur Arch Otorhinolaryngol       Date:  2016-03-08       Impact factor: 2.503

4.  Comparative study of two cefazolin prophylactic protocols in oncologic surgery of the larynx: A randomized trial.

Authors:  Mohammad Taghy; Khorsandi Ashtiani; Mohammad Sadeghi; Babak Saedi; Gilda Givechi
Journal:  Indian J Otolaryngol Head Neck Surg       Date:  2010-06-04

5.  Factors affecting wound complications in head and neck surgery: A prospective study.

Authors:  Devendra A Chaukar; Anuja D Deshmukh; Tanveer Majeed; Pankaj Chaturvedi; Prathamesh Pai; Anil K D'cruz
Journal:  Indian J Med Paediatr Oncol       Date:  2013-10
  5 in total

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