BACKGROUND: Although antimicrobial prophylaxis is mandatory in major clean-contaminated oncologic surgery of the head and neck, both the choice of specific antimicrobial compounds and the treatment duration are still discussed. METHODS: A prospective, randomized trial was carried out to compare efficacy and tolerability of clindamycin-cefonicid administered for 1 day versus 3 days in reducing the rate of wound and systemic infections. The following potential risk factors for surgical wound infection were evaluated: type of surgery, stage of disease, preoperative tracheostomy, preoperative radiotherapy, and diabetes mellitus. RESULTS:One-hundredsixty-two patients were evaluable; 81 received1-day chemoprophylaxis, while the remaining 81 were treated according to the 3-day schedule. During the first 20 days after surgery, wound infections occurred in 2 (2.5%) and 3(3.7%) patients, respectively, in the 1-day and 3-day treatment groups, so that no significant difference was found among the two evaluated chemoprophylaxis schedules. CONCLUSION: A 3-day schedule did not prove useful in preventing wound and systemic infections. All presumed risk factors were not associated with an increased rate of wound infections, although preoperative radiotherapy was associated with a greater severity of infections and a higher risk of late wound complications.
RCT Entities:
BACKGROUND: Although antimicrobial prophylaxis is mandatory in major clean-contaminated oncologic surgery of the head and neck, both the choice of specific antimicrobial compounds and the treatment duration are still discussed. METHODS: A prospective, randomized trial was carried out to compare efficacy and tolerability of clindamycin-cefonicid administered for 1 day versus 3 days in reducing the rate of wound and systemic infections. The following potential risk factors for surgical wound infection were evaluated: type of surgery, stage of disease, preoperative tracheostomy, preoperative radiotherapy, and diabetes mellitus. RESULTS: One-hundred sixty-two patients were evaluable; 81 received 1-day chemoprophylaxis, while the remaining 81 were treated according to the 3-day schedule. During the first 20 days after surgery, wound infections occurred in 2 (2.5%) and 3(3.7%) patients, respectively, in the 1-day and 3-day treatment groups, so that no significant difference was found among the two evaluated chemoprophylaxis schedules. CONCLUSION: A 3-day schedule did not prove useful in preventing wound and systemic infections. All presumed risk factors were not associated with an increased rate of wound infections, although preoperative radiotherapy was associated with a greater severity of infections and a higher risk of late wound complications.
Authors: Martinus C Oppelaar; Christian Zijtveld; Saskia Kuipers; Jaap Ten Oever; Jimmie Honings; Willem Weijs; Heiman F L Wertheim Journal: JAMA Otolaryngol Head Neck Surg Date: 2019-07-01 Impact factor: 6.223
Authors: Jeffrey D Bernstein; David J Bracken; Shira R Abeles; Ryan K Orosco; Philip A Weissbrod Journal: World J Otorhinolaryngol Head Neck Surg Date: 2022-04-18
Authors: Nicolas Penel; Charles Fournier; Micheline Roussel-Delvallez; Danièle Lefebvre; Ahmed Kara; Yann Mallet; Jean-Charles Neu; Jean-Louis Lefebvre Journal: Support Care Cancer Date: 2004-09 Impact factor: 3.603