Literature Review of Criteria for Defining Recipient-Site Infection after Oral Oncologic Surgery with Simultaneous Reconstruction

Akashi, Mitsuru; Kusumoto, Junya; Sakakibara, Akiko; Hashikawa, Kazunobu; Furudoi, Shungo; Komori, Takahide

doi:10.1089/sur.2017.101

Cited by 5 publications

(3 citation statements)

References 36 publications

(49 reference statements)

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“…In our study, flap dehiscence and fistula were the most common minor complications (17.5% overall, 10% in group A and 30% in group B). The main risk factors associated with fistula are ascribable to patient-related factors, such as poor nutritional status, systemic conditions that compromise wound healing (diabetes mellitus), previous treatments (radiotherapy and/or chemotherapy) and to surgical site-related factors, such as the clean/contaminated environment of the oral cavity (saliva and bacterial flora), infections, size of the defects after extensive resection and ischaemic complications of the flap 10 . Flap dehiscence with orocutaneous fistula after microvascular tongue reconstruction is a complication that decreases the patient’s quality of life, with prolonged hospitalisation and delayed start of adjuvant treatment.…”

Section: Discussionmentioning

confidence: 99%

Barbed suture in oral cavity reconstruction: preliminary results

Crosetti

Caracciolo

Arrigoni

et al. 2019

Acta Otorhinolaryngol Ital

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SUMMARYThe purpose of this study is to evaluate the efficacy and safety of unidirectional barbed suture (V-Loc) compared to a standard monofilament stitch (Vicryl) in suturing of a free flap to local tissue after head and neck surgery for squamous cell carcinoma of the oral cavity. Complication rates, operative closure time, length of hospitalisation and costs were evaluated. The study cohort (group A) of 20 consecutive patients reconstructed using barbed stitches for suturing was prospectively compared to a control cohort (group B) of 20 consecutive patients reconstructed using conventional vicryl stitches. All patients were affected by squamous cell carcinoma of the tongue and underwent different types of glossectomy and reconstruction with free flaps. This analysis demonstrates the efficacy of the barbed suture compared with a standard monofilament stitch in terms of lower complication rate (15% group A, 30% group B), intra-operative closure times (486 minutes group A, 517 minutes group B), and length of hospitalisation (average length of hospitalisation 14.60 days group A, 16.85 days group B). These factors coupled with the use of a lower number of stitches compared with the standard stitches may compensate the increased cost of the barbed suture. In conclusion, this study demonstrates that the use of unidirectional barbed stitches for suturing of a free flap to the recipient site reduces the complication rate, principally in terms of dehiscence and fistula incidence, and reduces intra-operative time and length of hospitalisation. Based on these results and on the literature, the use of unidirectional barbed stitches can be considered as a safe and efficient alternative to conventional stitches for suturing of free flaps to local tissue.

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Section: Discussionmentioning

confidence: 99%

Barbed suture in oral cavity reconstruction: preliminary results

Crosetti

Caracciolo

Arrigoni

et al. 2019

Acta Otorhinolaryngol Ital

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“…The predictive power of ANN was not validated in other populations, and therefore its generalizability could not be correctly determined. Finally, there is lack of uniformity of criteria for defining the SSI [ 55 ]. For example, the orocutaneous fistulas that did not meet the CDC criteria were not categorized as an SSI in some studies [ 56 , 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…For example, the orocutaneous fistulas that did not meet the CDC criteria were not categorized as an SSI in some studies [ 56 , 57 ]. However, some authors suggested that orocutaneous fistula caused by apparent infection such as abscess formation should be categorized as post-operative SSI [ 55 ]. The selection of different definition of SSI may cause a bias in the study.…”

Section: Discussionmentioning

confidence: 99%

Artificial neural network approach to predict surgical site infection after free-flap reconstruction in patients receiving surgery for head and neck cancer

Kuo

Chien

et al. 2018

Oncotarget

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BackgroundThe aim of this study was to develop an effective surgical site infection (SSI) prediction model in patients receiving free-flap reconstruction after surgery for head and neck cancer using artificial neural network (ANN), and to compare its predictive power with that of conventional logistic regression (LR).Materials and methodsThere were 1,836 patients with 1,854 free-flap reconstructions and 438 postoperative SSIs in the dataset for analysis. They were randomly assigned tin ratio of 7:3 into a training set and a test set. Based on comprehensive characteristics of patients and diseases in the absence or presence of operative data, prediction of SSI was performed at two time points (pre-operatively and post-operatively) with a feed-forward ANN and the LR models. In addition to the calculated accuracy, sensitivity, and specificity, the predictive performance of ANN and LR were assessed based on area under the curve (AUC) measures of receiver operator characteristic curves and Brier score.ResultsANN had a significantly higher AUC (0.892) of post-operative prediction and AUC (0.808) of pre-operative prediction than LR (both P<0.0001). In addition, there was significant higher AUC of post-operative prediction than pre-operative prediction by ANN (p<0.0001). With the highest AUC and the lowest Brier score (0.090), the post-operative prediction by ANN had the highest overall predictive performance.ConclusionThe post-operative prediction by ANN had the highest overall performance in predicting SSI after free-flap reconstruction in patients receiving surgery for head and neck cancer.

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The effect of antibiotic prophylaxis duration on infection rates and outcomes after head and neck reconstruction with bony free flaps and hardware

Chacko,

Galochkina,

Lee

et al. 2024

American Journal of Otolaryngology

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Literature Review of Criteria for Defining Recipient-Site Infection after Oral Oncologic Surgery with Simultaneous Reconstruction

Abstract: Reconsideration of the categorization of orocutaneous fistula as infection, regardless of the etiology, and differentiation of superficial and deep incisional infections are necessary for correct assessment of recipient-site infection in oral oncologic surgery.

Cited by 5 publications

References 36 publications

Barbed suture in oral cavity reconstruction: preliminary results

Barbed suture in oral cavity reconstruction: preliminary results

Artificial neural network approach to predict surgical site infection after free-flap reconstruction in patients receiving surgery for head and neck cancer

The effect of antibiotic prophylaxis duration on infection rates and outcomes after head and neck reconstruction with bony free flaps and hardware

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