BACKGROUND: Surgical site infections (SSIs) occur at a rate exceeding 40 % after head and neck reconstruction and are due in part to the clean-contaminated surgical field, in which cutaneous fields interact with oral or pharyngeal fields. The aim of this study was to clarify the most important risk factors for SSI and to identify effective strategies for preventing SSI. METHODS: In 2011 and 2012, 197 patients who underwent head and neck reconstructive surgery were studied at National Cancer Center Hospital East, Japan. The SSI rate, risk factors for SSI, and biological aspects of SSI were evaluated prospectively. RESULTS: A total of 42 patients (21.3 %) had SSIs, and 62 bacterial species were identified at infection sites. Significant risk factors for SSI identified with multivariate analysis were hypoalbuminemia [P = 0.002, odds ratio (OR) = 3.37], reconstruction with vascularized bone transfer (P = 0.006, OR = 3.99), and a poor American Society of Anesthesiologists Physical Status score (P = 0.041, OR = 3.00). Most bacteria identified were species that persist around cutaneous and pharyngeal fields, but multidrug-resistant bacteria were rare. CONCLUSIONS: The SSI rate at our hospital is lower than rates in previous studies. To minimize SSI, intervention to improve the patient's perisurgical nutritional status and a more appropriate mandible reconstructive strategy should be considered.
BACKGROUND: Surgical site infections (SSIs) occur at a rate exceeding 40 % after head and neck reconstruction and are due in part to the clean-contaminated surgical field, in which cutaneous fields interact with oral or pharyngeal fields. The aim of this study was to clarify the most important risk factors for SSI and to identify effective strategies for preventing SSI. METHODS: In 2011 and 2012, 197 patients who underwent head and neck reconstructive surgery were studied at National Cancer Center Hospital East, Japan. The SSI rate, risk factors for SSI, and biological aspects of SSI were evaluated prospectively. RESULTS: A total of 42 patients (21.3 %) had SSIs, and 62 bacterial species were identified at infection sites. Significant risk factors for SSI identified with multivariate analysis were hypoalbuminemia [P = 0.002, odds ratio (OR) = 3.37], reconstruction with vascularized bone transfer (P = 0.006, OR = 3.99), and a poor American Society of Anesthesiologists Physical Status score (P = 0.041, OR = 3.00). Most bacteria identified were species that persist around cutaneous and pharyngeal fields, but multidrug-resistant bacteria were rare. CONCLUSIONS: The SSI rate at our hospital is lower than rates in previous studies. To minimize SSI, intervention to improve the patient's perisurgical nutritional status and a more appropriate mandible reconstructive strategy should be considered.
Authors: Ahmed Sam Beydoun; Kevin Koss; Tyson Nielsen; Andrew James Holcomb; Priscilla Pichardo; Nicholas Purdy; Aaron L Zebolsky; Chase M Heaton; Caitlin P McMullen; Jessica A Yesensky; Michael G Moore; Neerav Goyal; Joshua Kohan; Mirabelle Sajisevi; Kenneth Tan; Daniel Petrisor; Mark K Wax; Alexandra E Kejner; Zain Hassan; Skylar Trott; Andrew Larson; Jeremy D Richmon; Evan M Graboyes; C Burton Wood; Ryan S Jackson; Patrik Pipkorn; Jennifer Bruening; Becky Massey; Sidharth V Puram; Joseph Zenga Journal: JAMA Otolaryngol Head Neck Surg Date: 2022-06-01 Impact factor: 8.961
Authors: Ana Ramos-Zayas; Francisco López-Medrano; Irene Urquiza-Fornovi; Ignacio Zubillaga; Ramón Gutiérrez; Gregorio Sánchez-Aniceto; Julio Acero; Fernando Almeida; Ana Galdona; María José Morán; Marta Pampin; José Luis Cebrián Journal: Cancers (Basel) Date: 2021-04-27 Impact factor: 6.639
Authors: Menghan Shi; Zhengxue Han; Lizheng Qin; Ming Su; Yanbin Liu; Man Li; Long Cheng; Xin Huang; Zheng Sun Journal: J Int Med Res Date: 2020-08 Impact factor: 1.671