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Head Neck. 2016 Apr;38 Suppl 1:E392-8. doi: 10.1002/hed.24005. Epub 2015 Aug 6.

Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project.

Author information

1
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
2
Department of Nursing, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
3
Infectious Disease Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
4
Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.

Abstract

BACKGROUND:

Compliance with Surgical Care Improvement Project (SCIP) parameters regarding antibiotic prophylaxis may affect surgical site infection rates. The purpose of this study was for us to report SCIP compliance, surgical site infection rates, and risk factors in a large series of head and neck free flap surgeries.

METHODS:

A retrospective review of 480 free flap cases was performed. Surgical site infections occurring within 30 days postoperatively were noted.

RESULTS:

Surgical site infection occurred in 13.3% of cases. Prophylaxis was given in 99.8% of cases; ampicillin-sulbactam (83%) and clindamycin (9%) were most common. Prophylaxis was "on-time" in 92.3% of cases. There were no significant associations between surgical site infection and tumor stage, American Society of Anesthesiologists (ASA) classification, tumor subsite, or flap type. Prior radiation was a risk factor for surgical site infection in patients treated for malignancy.

CONCLUSION:

A surgical site infection rate of 13.3% was noted. In this cohort, with a compliance rate with prophylactic antibiotic measures, prior radiation was found to be a risk factor only in patients with cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E392-E398, 2016.

KEYWORDS:

antibiotic prophylaxis; free flap; head and neck cancer; microvascular reconstruction; surgical site infection

PMID:
25641048
DOI:
10.1002/hed.24005
[Indexed for MEDLINE]

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