Hiroshi Nobuhara1, Yasuhiro Matsugu2, Sakiko Soutome3, Saki Hayashida4, Takumi Hasegawa5, Masaya Akashi5, Shin-Ichi Yamada6, Hiroshi Kurita6, Hirokazu Nakahara7, Miyuka Nakahara7, Nobuhiro Ueda8, Tadaaki Kirita8, Tomohisa Nakamura9, Yasuyuki Shibuya9, Kazuyo Mori10, Taihei Yamaguchi11. 1. Department of Dentistry, Hiroshima Prefectural Hospital, Japan. 2. Department of Clinical Nutrition, Hiroshima Prefectural Hospital, Japan; Department of Gastroenterological, Breast, and Transplant Surgery, Hiroshima Prefectural Hospital, Japan. Electronic address: y-matsugu@hph.pref.hiroshima.jp. 3. Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, Japan. 4. Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Japan. 5. Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Japan. 6. Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Japan. 7. Osaka City University Graduate School of Medicine Department of Oral and Maxillofacial Surgery, Japan. 8. Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan. 9. Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, Japan. 10. Section of Oral Hygiene, Kagoshima University Hospital, Japan. 11. Department of Preventive Dentistry, Kagoshima University, Japan.
Abstract
BACKGROUND: Surgical site infection is a common postoperative complication of colorectal cancer surgery, and surgical site infection increases medical costs, prolongs hospitalization, and worsens long-term prognosis. Perioperative oral care has been reported to be effective in preventing postoperative pneumonia, although there are only a few reports on its effectiveness in preventing surgical site infection. This study aimed to determine the role of perioperative oral care in surgical site infection prevention after colorectal cancer surgery. METHODS: In this study, 1,926 patients with colorectal cancer from 8 institutions were enrolled; 808 patients (oral care group) received perioperative oral care at the hospital's dental clinic, and 1,118 (control group) did not receive perioperative oral care. The data were matched by propensity score to reduce bias. Ultimately, a total of 1,480 patients were included in the analysis. RESULTS: The incidence of surgical site infection was significantly lower in the oral care group than in the control group (8.4% vs 15.7%, P < .001). Multivariate logistic regression analysis revealed 4 independent risk factors for surgical site infection: low albumin level, rectal cancer, blood loss, and lack of perioperative oral care. Lack of perioperative oral care had an odds ratio of 2.100 (95% confidence interval 1.510-2.930, P < .001). CONCLUSION: These results suggest that perioperative oral care can reduce the incidence of surgical site infection after colorectal cancer resection. Perioperative oral care may have an important role in the future perioperative management of colorectal cancer as a safe and effective method of surgical site infection prevention, although further validation in prospective studies is needed.
BACKGROUND: Surgical site infection is a common postoperative complication of colorectal cancer surgery, and surgical site infection increases medical costs, prolongs hospitalization, and worsens long-term prognosis. Perioperative oral care has been reported to be effective in preventing postoperative pneumonia, although there are only a few reports on its effectiveness in preventing surgical site infection. This study aimed to determine the role of perioperative oral care in surgical site infection prevention after colorectal cancer surgery. METHODS: In this study, 1,926 patients with colorectal cancer from 8 institutions were enrolled; 808 patients (oral care group) received perioperative oral care at the hospital's dental clinic, and 1,118 (control group) did not receive perioperative oral care. The data were matched by propensity score to reduce bias. Ultimately, a total of 1,480 patients were included in the analysis. RESULTS: The incidence of surgical site infection was significantly lower in the oral care group than in the control group (8.4% vs 15.7%, P < .001). Multivariate logistic regression analysis revealed 4 independent risk factors for surgical site infection: low albumin level, rectal cancer, blood loss, and lack of perioperative oral care. Lack of perioperative oral care had an odds ratio of 2.100 (95% confidence interval 1.510-2.930, P < .001). CONCLUSION: These results suggest that perioperative oral care can reduce the incidence of surgical site infection after colorectal cancer resection. Perioperative oral care may have an important role in the future perioperative management of colorectal cancer as a safe and effective method of surgical site infection prevention, although further validation in prospective studies is needed.
Authors: Yuki Sakamoto; Arisa Tanabe; Makiko Moriyama; Yoshihiko Otsuka; Madoka Funahara; Sakiko Soutome; Masahiro Umeda; Yuka Kojima Journal: Int J Environ Res Public Health Date: 2022-06-21 Impact factor: 4.614