Prophylactic antibiotics administration head and neck cancer surgery with major flap reconstruction: 1-day cefoperazone versus 5-day cefotaxime.

Patients who undergo surgery of the head and neck cancer with major flap reconstruction, benefit from perioperative antibiotic prophylaxis. Head and neck surgery, especially ablative cancer surgery with major flap reconstruction is potentially contaminated iatrogenic wound, and the use of preoperative, perioperative and post operative chemoprophylaxis for infection is mandatory. This study is being done to determine if shorter course of antibiotic administration (Cefoperazone) would be more effective than conventional 5-day antibiotic administration (Cefotaxime). Patients who are identified as requiring major flap reconstruction after extensive ablative surgery for head and neck cancer, are considered as potential candidates for this study. The choice of ideal antibiotics and duration period are still under discussion. Patients were assigned randomly to receive Cefoperazone sodium for either 24 hr. (study group) or Cefotaxime sodium for 120 hr. (control group). A total of fifty patients were studied. The incidence of wound infection, flap death and major complications are evaluated. Out of the fifty patients studied, twenty-eight were assigned to 1-day prophylaxis. Incidence of failure of prophylaxis (F. P.) was 7.1% in this group. Twenty-two patients were assigned to 5-day prophylaxis, in whom F. P. rate was 9.8%. This study suggests that, there is no beneficial effect from administration of antibiotics for more than 24 hr. postoperatively in patients two undergo major flap reconstruction for head and neck cancer after extensive radical ablation surgery.