Surgical site infection in clean-contaminated head and neck cancer surgery: risk factors and prognosis

Abstract

Since new treatment strategies, such as chemoradiotherapy, have been introduced for head and neck cancer, a higher number of unknown factors may be involved in surgical site infection in clean-contaminated head and neck cancer surgery. The aim of the present study was to clarify the risk factors of surgical site infection in clean-contaminated surgery for head and neck cancer and the prognosis of patients with surgical site infection. Participants were 277 consecutive patients with head and neck cancer who underwent clean-contaminated surgery for primary lesions at the Aichi Cancer Center over a 60-month period. A total of 22 putative risk factors were recorded in each patient and statistically analyzed to elucidate surgical site infection related factors. Surgical site infection was observed in 92 (32.1 %) of 277 cases. Univariate analysis indicated that alcohol consumption, T classification, neck dissection, reconstructive procedure, and chemoradiotherapy were significantly associated with surgical site infection. Multiple logistic regression analysis identified two independent risk factors for surgical site infection: reconstructive surgery (p = 0.04; odds ratio (OR) 1.77) and chemoradiotherapy (p = 0.01; OR 1.93). In spite of surgical site infection, the five-year overall survival rate of patients with surgical site infection was not significantly different from those without surgical site infection. Although surgical site infection did not impact the overall survival of patients with surgical procedures, head and neck surgeons should pay attention to patients with previous chemoradiotherapy as well as to those with a high risk of surgical site infection requiring reconstructive surgery.

Anti-biofilm properties of wound dressing incorporating nonrelease polycationic antimicrobials

“…Moreover, post-surgery wounds are prone to life-threatening infections mainly in immune-deficient patients and in cancer patients who are at greater risk for nosocomial infections [1]. Unfortunately, despite adequate antibiotic prophylaxis, post-operative surgical site infection develops in up to 40% of cases [2].…”

Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

“…Radiation, surgery, surgery on the side of the port, neck dissection, neck dissection on the side of the port, and chemotherapy were not shown to represent independent risk factors for dual-lumen chest port infection in the HNC population. The effect of local irradiation on catheterrelated complications is controversial, although Hirakawa et al [3] found that patients with a prior history of chemoradiation were at an increased risk for surgical site infection (p = 0.01). Surgery and surgery on the side of the port both approached statistical significance as risk factors (p = 0.08 and 0.09, respectively) in the current study.…”

“…Given that HNC patients make up the largest population that receive chest ports at our institution, these data are imperative for improving patient care. HNC patients have several risk factors that may predispose them to higher rates of infection, including history of local irradiation and tracheostomy [2,3]. In the current study, we evaluated several treatments observed in the HNC population to determine possible independent risk factors for dual-lumen chest port infection in this population.…”

“…Implantable chest ports are routinely placed by interventional radiologists for this indication to provide long-term venous access in these patients. HNC patients may have confounding factors that predispose them to higher rates of chest port infections, including local neck irradiation that affects wound healing and tracheostomy that threatens the sterile procedural field [2][3][4].…”

Hospital hygienic surveillance studies and their application

“…The In the article written by Hirakawa et al in 2012, the SSI did not change the fiveyear survival of the patients [103].…”