[Risk factors in surgical wound infection in oncological surgery of the head and neck].

Although the use of antibiotic prophylaxis has significantly reduced the frequency of postoperative wound infections, they continue to be a critical issue in head and neck cancer surgery. A study was made of possible risk factors for the development of these infections. A prospective study was made of 159 patients with pharyngo-laryngeal squamous-cell carcinoma who underwent open-pharynx surgery in order to analyze the factors associated with wound infections. Postoperative wound infection was defined as purulent drainage or mucocutaneous fistula formation, or both, in the first 10 days after surgery. Potential risk factors examined were age, medical illnesses, prior surgery and radiotherapy, TNM stage, type of operative procedure, method of reconstruction, and operative time. The overall wound infection rate was 23%. Although the incidence of wound infection was higher in patients who received preoperative radiotherapy, in patients with advanced stage disease, and in those who required flap reconstruction, the only preoperative factor that significantly increased the rate of wound infection was the concurrence of medical illnesses (chronic obstructive pulmonary disease and diabetes mellitus; p = 0.018). In conclusion, the presence of prior medical diseases was the main risk factor in the development of postoperative wound infections.