Schuderer, Johannes G. and Spoerl, Steffen and Spanier, Gerrit and Gottsauner, Maximilian and Gessner, Andre and Hitzenbichler, Florian and Meier, Johannes K. and Reichert, Torsten E. and Ettl, Tobias (2022) Surgical and remote site infections after reconstructive surgery of the head and neck: A risk factor analysis. JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY, 50 (2). pp. 178-187. ISSN 1010-5182, 1878-4119
Full text not available from this repository. (Request a copy)Abstract
The aim of this study was to identify risk factors for surgical (SSI) and remote site (RSI) infections, pathogens and antibiotic resistances in patients after pedicled and free flap reconstruction in the head and neck area. SSI criteria implicated infections affecting superficial or deep tissue in the flap area with purulent discharge, fistula, abscess formation and local infections signs. RSI criteria were defined as infections remote from the surgical site presenting with systemic symptoms like fever, leucocytosis, increase in C-reactive protein, purulent tracheobronchial secretion or deterioration of blood gases. Focus adequate specimen sampling and aerobic and anaerobic incubation and cultivation was performed. Epidemiological data, factors directly related to surgery or reconstruction, perioperative antibiotic regimen, length of stay, autologous blood transfusion and microbiological aspects were retrospectively analysed in 157 patients. 10.8% of patients presented SSI, 12.7% RSI. Cultivated bacteria were sampled from flap sites, blood cultures, central catheters and sputum including mainly gram-negative bacteria (70.3%) being frequently resistant against penicillin (85%) and third generation cephalosporine derivates (48%). Autologous blood transfusion (p = 0.018) and perioperative clindamycin use (p = 0.002) were independent risk factors for overall (SSI and RSI combined) infections. Prior radiation (p = 0.05), autologous blood transfusion (p = 0.034) and perioperative clindamycin use (p = 0.004) were predictors for SSIs. ASA >2 (p = 0.05) was a risk factor for remote site infections and prolonged ICU stay (p = 0.002) was associated with overall infections, especially in irradiated patients. Efforts need to be made in improving patient blood management, antibiotic stewardship and accurate postoperative care to avoid postoperative infections after head and neck reconstructive surgery. (c) 2021 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | FREE-FLAP; ANTIBIOTIC-RESISTANCE; AMERICAN-COLLEGE; CDC DEFINITIONS; WOUND-INFECTION; TRANSFUSION; MICROBIOLOGY; COMPLICATIONS; CHEMOTHERAPY; PROPHYLAXIS; Surgical site infections; Free flap reconstruction; Risk factors; Antibiotic resistance |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Medizinische Mikrobiologie und Hygiene Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie Medicine > Abteilung für Krankenhaushygiene und Infektiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 21 Nov 2023 15:52 |
| Last Modified: | 21 Nov 2023 15:52 |
| URI: | https://pred.uni-regensburg.de/id/eprint/56769 |
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