Risk factors for surgical site infection in free‐flap reconstructive surgery for head and neck cancer: Retrospective Australian cohort study. Issue 11 (18th August 2021)

• Record Type: Journal Article
• Authors: Gearing, Peter Francis; Daly, John Frederick; Tang, Nicholas Shi Jie; Singh, Kasha; Ramakrishnan, Anand
• Is Part Of: Head & neck. Volume 43:Issue 11(2021)
• Page Start: 3417
• Page End: 3428
• Publication Date: 2021-08-18
• Subjects: antibiotic prophylaxis -- free‐flap -- head and neck cancer -- risk factors -- surgical site infection; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26837
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Surgical site infections (SSI) are common complications of free‐flap reconstruction for head and neck cancer defects. This study aimed to identify risk factors for SSI following a significant change in local antibiotic prophylaxis practice. Methods: A retrospective cohort study was conducted of 325 patients receiving free‐flap reconstruction for head and neck cancer defects at a tertiary hospital in Melbourne, Australia between 2013 and 2019. Charts were queried for recipient SSI (primary outcome), donor SSI, other infections, antibiotic use, hospital length of stay, and mortality. Results: Risk factors for SSI included female sex, T‐classification, hardware insertion, clindamycin prophylaxis, and operative duration. There was a trend toward increased SSI with shorter ≤24 h prophylaxis (OR: 0.43). Conclusion: Antibiotic duration and type were associated with SSI. Complexity of surgery, T‐classification, hardware use, and operative duration were also independently associated with SSI. A prospective trial is indicated to elicit optimal prophylactic antibiotic duration.