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Preliminary report of associated factors in wound infection after major head and neck neoplasm operations — does the duration of prophylactic antibiotic matter?

Published online by Cambridge University Press:  20 April 2007

S-A Liu ,
K-C Tung ,
J-Y Shiao  and
Y-T Chiu
S-A Liu
Affiliation:
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
K-C Tung
Affiliation:
Department of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
J-Y Shiao
Affiliation:
Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan
Y-T Chiu*
Affiliation:
Department of Education and Research, Taichung Veterans General Hospital, Taichung, Taiwan
*
Address for correspondence: Y-T Chiu, Department of Education and Research, Taichung Veterans General Hospital, No. 160 Sec. 3, Chung-Kang Road, Taichung, Taiwan. Fax: 886 4 23596868 E-mail: [email protected]
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Abstract

The aim of this study was to investigate whether an extended course of prophylactic antibiotic could reduce the wound infection rate in a subtropical country. Fifty-three consecutive cases scheduled to receive major head and neck operations were randomised into one-day or three-day prophylactic antibiotic groups. Thirteen cases (24.5 per cent) developed wound infections after operations. The duration of prophylactic antibiotic was not related to the surgical wound infection. However, pre-operative haemoglobulin less than 10.5 g/dl (odds ratio: 7.24, 95 per cent confidence interval: 1.28–41.0) and reconstruction with a free flap or pectoris major myocutaneous flap during the operation (odds ratio: 11.04, 95 per cent confidence interval: 1.17–104.7) were associated factors significantly influencing post-operative wound infection. Therefore, one day of prophylactic antibiotic was effective in major head and neck procedures but should not be substituted for proper aseptic and meticulous surgical techniques.

Keywords

Head and Neck NeoplasmsWound InfectionProphylactic AntibioticsOtorhinolaryngological Surgical Procedures
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 4 , April 2008 , pp. 403 - 408
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 McDonald, LC, Yu, HT, Yin, HC, Hsiung, AC, Ho, M. Use and abuse of surgical antibiotic prophylaxis in hospitals in Taiwan. J Formos Med Assoc 2001;100:5–13Google ScholarPubMed
2 Boyce, JM. Consequences of inaction: Importance of infection control practices. Clin Infect Dis 2001;33(suppl 3):S133–7CrossRefGoogle ScholarPubMed
3 Classen, DC, Evans, RS, Pestotnik, SL, Horn, SD, Menlove, RL, Burke, JP. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med 1992;326:281–6CrossRefGoogle ScholarPubMed
4 Becker, GD, Parell, GJ. Cefazolin prophylaxis in head and neck cancer surgery. Ann Otol Rhinol Laryngol 1979;88:183–6CrossRefGoogle ScholarPubMed
5 Johnson, JT, Yu, VL, Myers, EN, Muder, RR, Thearle, PB, Diven, WF. Efficacy of two third-generation cephalosporins in prophylaxis for head and neck surgery. Arch Otolaryngol 1984;110:224–7CrossRefGoogle ScholarPubMed
6 Johnson, JT, Myers, EN, Thearle, PB, Sigler, BA, Schramm, VL. Antimicrobial prophylaxis for contaminated head and neck surgery. Laryngoscope 1984;94:46–51CrossRefGoogle ScholarPubMed
7 Johnson, JT, Kachman, K, Wagner, RL, Myers, EN. Comparison of ampicillin/sulbactam versus clindamycin in the prevention of infection in patients undergoing head and neck surgery. Head Neck 1997;19:367–713.0.CO;2-Y>CrossRefGoogle ScholarPubMed
8 Fee, WE Jr, Glenn, M, Handen, C, Hopp, ML. One day vs. two days of prophylactic antibiotics in patients undergoing major head and neck surgery. Laryngoscope 1984;94:612–14CrossRefGoogle ScholarPubMed
9 Carroll, WR, Rosenstiel, D, Fix, JR, de, la Torre, J, Solomon, JS, Brodish, B et al. Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck. Arch Otolaryngol Head Neck Surg 2003;129:771–4Google Scholar
10 Johnson, JT, Yu, VL. Antibiotic use during major head and neck surgery. Ann Surg 1988;207:108–11CrossRefGoogle ScholarPubMed
11 Liu, YC, Huang, WK, Huang, TS, Kunin, CM. Extent of antibiotic use in Taiwan shown by antimicrobial activity in urine. Lancet 1999;354:1360Google Scholar
12 Su, HY, Ding, DC, Chen, DC, Lu, MF, Liu, JY, Chang, FY. Prospective randomized comparison of single-dose versus 1-day cefazolin for prophylaxis in gynecologic surgery. Acta Obstet Gynecol Scand 2005;84:384–9Google Scholar
13 Sheen-Chen, SM, Cheng, YF, Chou, FF, Lee, TY. Postoperative T-tube cholangiography: is routine antibiotic prophylaxis necessary? A prospective, controlled study. Arch Surg 1995;130:20–3CrossRefGoogle ScholarPubMed
14 Mangram, AJ, Horan, TC, Pearson, ML, Silver, LC, Jarvis, WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999;20:250–78CrossRefGoogle ScholarPubMed
15 Rubin, J, Johnson, JT, Wagner, RL, Yu, VL. Bacteriologic analysis of wound infection following major head and neck surgery. Arch Otolaryngol Head Neck Surg 1988;114:969–72CrossRefGoogle ScholarPubMed
16 Schwartz, SR, Yueh, B, Maynard, C, Daley, J, Henderson, W, Khuri, SF. Predictors of wound complications after laryngectomy: A study of over 2000 patients. Otolaryngol Head Neck Surg 2004;131:61–8CrossRefGoogle ScholarPubMed
17 Penel, N, Lefebvre, D, Fournier, C, Sarini, J, Kara, A, Lefebvre, JL. Risk factors for wound infection in head and neck cancer surgery: a prospective study. Head Neck 2001;23:447–55CrossRefGoogle ScholarPubMed
18 Fergusson, D, Khanna, MP, Tinmouth, A, Hebert, PC. Transfusion of leukoreduced red blood cells may decrease postoperative infections: two meta-analyses of randomized controlled trials. Can J Anaesth 2004;51:417–24Google Scholar
19 Girod, DA, McCulloch, TM, Tsue, TT, Weymuller, EA. Risk factors for complications in clean-contaminated head and neck surgical procedures. Head Neck 1995;17:7–13Google Scholar