Antibiotic prophylaxis in uncontaminated neck dissection

Li-Xing Man, Daniel M Beswick, Jonas T Johnson
Laryngoscope 2011, 121 (7): 1473-7

OBJECTIVES/HYPOTHESIS: To describe our institution's experience with antibiotic prophylaxis in uncontaminated neck dissection and to identify risk factors associated with postoperative wound infection.

STUDY DESIGN: Retrospective chart review.

METHODS: Between April 2006 and June 2010, 244 patients underwent 273 uncontaminated neck dissections at a single tertiary care center. Patient factors, operative details, and postoperative complications were recorded. Patients were separated into three groups: no prophylactic antibiotics, intraoperative antibiotics only, and intra- and postoperative antibiotics.

RESULTS: Wound infections occurred after nine of the 273 procedures (3.3%). All of the wound infections occurred in patients receiving intraoperative antibiotics only (4 of 157) or intra- and postoperative antibiotics (5 of 75) (P = .11). The development of a wound infection was not associated with age, sex, history of tobacco and alcohol use, history of head and neck surgery, or history of radiation or chemotherapy. Wound infection was independently associated with operative time (adjusted odds ratio, 1.35; 95% confidence interval, 1.07-1.71; P = .011, for each additional hour of surgery) and with radical or extended neck dissection (adjusted odds ratio, 14.61; 95% confidence interval, 2.37-90.01, P = .004).

CONCLUSIONS: Our data did not support the use of antibiotic prophylaxis in routine uncontaminated neck dissection. Prophylactic antibiotics, however, may be indicated for more extensive lymphadenectomy procedures.

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