Risk factors for surgical-site infections in head and neck cancer surgery

Carlos Jorge Lotfi, Rita de Cássia Cavalcanti, Adriana Maria Costa e Silva, Maria do Rosário Dias de Oliveira Latorre, Karina de Cássia Braga Ribeiro, André Lopes Carvalho, Luiz Paulo Kowalski
Otolaryngology—Head and Neck Surgery 2008, 138 (1): 74-80

OBJECTIVE: The aim of this study was to identify risk factors for surgical-site infections (SSIs) in patients with head and neck cancer submitted to major clean-contaminated surgery.

STUDY DESIGN: This is a prospective study conducted in a tertiary cancer center hospital.

SUBJECTS AND METHODS: This study includes 258 patients submitted to a major clean-contaminated head and neck oncologic surgery.

RESULTS: The overall SSI rate was 38.8%. The univariate analysis showed the following significant risk factors: race, tobacco consumption, clinical stage, comorbidities, time duration of the surgical procedure, and flap reconstruction. The final model by logistic regression identified the following independent predictors for SSI: tobacco consumption (odds ratio [OR] = 2.96), presence of metastatic lymph nodes (OR = 2.05), flap reconstruction (OR = 2.20), and antimicrobial prophylaxis exceeding 48 hours (OR=1.89).

CONCLUSION: The high-risk patients for SSI in head and neck oncologic surgery were those with cancer at advanced stages, those who were smokers, those presenting comorbidities, those who needed major reconstruction of the surgical wound, or those who were submitted to inadequate antibiotic prophylaxis.

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