Oropharyngeal Contamination Predisposes to Complications after Neck Dissection

Jain, Umang; Somerville, Jessica; Saha, Sujata; Hackett, Nicholas J.; Halen, Jon P. Ver; Antony, Anuja K.; Samant, Sandeep

doi:10.1177/0194599815581808

Cited by 10 publications

(14 citation statements)

References 47 publications

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“…The larger the tumor size, the larger and more complex the wound. Wound exudation that contains fibrin promotes surface reepithelialization, while excessive fluid increases the dead space . It may induce surgical site infection in the surgical region.…”

Section: Discussionmentioning

confidence: 99%

“…Tissue breakdown, such as flap necrosis, may result in contamination and vessel exposure in the neck area . Previous studies have shown that exacerbation of flap necrosis results in the resident flora and saliva enzymes of the mouth affecting the neck area and inducing infection and postoperative hemorrhage. A retrospective analysis on head and neck tumor surgery and reconstruction by Smith suggested that consideration of the medical situation and flap choice is important to protect the patient from complications.…”

Section: Discussionmentioning

confidence: 99%

“…Flap complications and failures were defined in this study according to Smith . Surgical site infection was defined in this study according to Jain, Mazurek, and Kamizono …”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study

Huang

Chen

et al. 2019

Head & Neck

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AbstarctBackground: Postoperative hemorrhage is one of the life-threatening complications of oral cancer surgery. The purpose of this study was to identify the risk factors in a large cohort. Patients and methods: Patients with oral squamous cell carcinoma who had received surgery were enrolled. The variables between patients with and without postoperative hemorrhage were compared using univariate and multivariate models. Results: Of the 1513 patients (or 1581 cases) enrolled in the study, 34 patients suffered from postoperative hemorrhage. In the univariate analysis, cigarette, and alcohol consumption, floor of mouth tumors, T4 classified tumors, flap reconstruction, surgical site infection, and flap necrosis were risk factors for postoperative hemorrhage. In the multivariate model, flap necrosis and surgical site infection were independent risk factors for postoperative hemorrhage. Conclusions: The patients with surgical site infection or flap necrosis should be closely monitored in order to avoid postoperative hemorrhage. K E Y W O R D S oral squamous cell carcinoma, radical surgery, postoperative hemorrhage, retrospective study, risk factor

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study

Huang

Chen

et al. 2019

Head & Neck

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“…Finally, 12 studies that fit the inclusion criteria plus the current study performed by the authors were enrolled in the systematic review (Table 3). [1][2][3]5,9,[16][17][18][19][20][21][22] Figure 2 and Table 3 show the selection process and an overview of the excluded studies. All included studies used administrative data, and all studies except the present one were performed in the United States.…”

Section: Systematic Reviewmentioning

confidence: 99%

Associations of Volume and Thyroidectomy Outcomes

Liang

Liu

Mok

et al. 2016

Otolaryngol.--head neck surg.

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This meta-analysis showed that patients who received thyroidectomies performed by high-volume hospitals and surgeons had shorter LOS and lower costs compared with those treated by low-volume hospitals and surgeons. In addition, in-hospital survival rates were better in patients treated by high-volume surgeons. Further research is needed to define the learning curve for thyroidectomy and to clarify how hospital volume and surgeon volume affect its success rate.

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“…Dissecting the neck in patients with oral cancer increases pathways of communication between it and the oral cavity, which heightens the probability of indigenous oral bacteria migrating to the former. In some patients, a reduction in perioperative oral ingestion can result in compromised nutrition, thus greatly increasing the risk of a postoperative surgical site infection (SSI) 6) . The purpose of this study was to investigate neck infections after neck dissection in oral cancer patients with the aims of elucidating the development of SSIs and their relationship with the results of bacterial culture.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

Iwamoto

Morikawa

Narita

et al. 2020

Bull. Tokyo Dent. Coll.

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During dissection for oral cancer, there is a high probability of bacteria indigenous to the oral cavity migrating to the surgical field in the neck due to the opening of new pathways of communication with the oral cavity. The risk of postoperative surgical site infection (SSI) in such patients is high due to malnutrition arising from perioperative eating disorders and dysphagia. Neck infections after neck dissection in oral cancer patients were investigated to elucidate the development of SSIs and their relationship with the results of bacterial culture.A total of 86 patients with oral squamous cell carcinoma who underwent neck dissection between January 2012 and December 2016 were enrolled. Ten factors were selected for investigation: (1) sex; (2) age; (3) primary site; (4) type of dissection; (5) whether or not there was a new pathway of communication between the oral cavity and the neck; (6) operative time; (7) blood loss; (8) number of drainage days; (9) amount of drainage at the time of drain removal; and (10) whether or not there was an SSI. Bacteria isolated from the catheter tip on drain removal were also investigated. Significant differences were observed between patients with and without SSIs (p-0.010) according to the presence of a new pathway of communication between the oral cavity and the neck (p-0.004); operative time (p-0.007); number of drainage days (p-0.029); or the amount of drainage at the time of drain removal. The present results indicate that selecting antibiotics appropriate to each patient and administering perioperative oral care are important in preventing SSIs.

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Oropharyngeal Contamination Predisposes to Complications after Neck Dissection

Abstract: Using the ACS-NSQIP data set, this study found an increased risk of surgical complications in the setting of contaminated neck dissections. These data should be used for patient risk stratification, informed consent, and to guide further research.

Cited by 10 publications

References 47 publications

Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study

Risk factors for postoperative hemorrhage in patients with oral squamous cell carcinoma: A retrospective study

Associations of Volume and Thyroidectomy Outcomes

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

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