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Statistical Analysis of Surgical Site Infection After Head and Neck Reconstructive Surgery

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Surgical site infections (SSIs) occur at a rate exceeding 40 % after head and neck reconstruction and are due in part to the clean-contaminated surgical field, in which cutaneous fields interact with oral or pharyngeal fields. The aim of this study was to clarify the most important risk factors for SSI and to identify effective strategies for preventing SSI.

Methods

In 2011 and 2012, 197 patients who underwent head and neck reconstructive surgery were studied at National Cancer Center Hospital East, Japan. The SSI rate, risk factors for SSI, and biological aspects of SSI were evaluated prospectively.

Results

A total of 42 patients (21.3 %) had SSIs, and 62 bacterial species were identified at infection sites. Significant risk factors for SSI identified with multivariate analysis were hypoalbuminemia [P = 0.002, odds ratio (OR) = 3.37], reconstruction with vascularized bone transfer (P = 0.006, OR = 3.99), and a poor American Society of Anesthesiologists Physical Status score (P = 0.041, OR = 3.00). Most bacteria identified were species that persist around cutaneous and pharyngeal fields, but multidrug-resistant bacteria were rare.

Conclusions

The SSI rate at our hospital is lower than rates in previous studies. To minimize SSI, intervention to improve the patient’s perisurgical nutritional status and a more appropriate mandible reconstructive strategy should be considered.

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Acknowledgment

This work was supported by National Cancer Center Research and Development Fund 23-A-26. This study was performed in conformity with the Declaration of Helsinki. Kenichi Kamizono and Minoru Sakuraba performed statistical analysis. Kenichi Kamizono, Shogo Nagamatsu, Minoru Sakuraba, Shimpei Miyamoto, and Ryuichi Hayashi performed operations.

Disclosure

The authors have no commercial associations or financial disclosures that might pose or create a conflict of interest with the information presented in this article

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Authors and Affiliations

  1. Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Chiba, Japan

    Kenichi Kamizono MD, Minoru Sakuraba MD, PhD & Shogo Nagamatsu MD, PhD

  2. Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan

    Shimpei Miyamoto MD, PhD

  3. Department of Head and Neck Surgery, National Cancer Center Hospital East, Chiba, Japan

    Ryuichi Hayashi MD

  4. Department of Plastic Surgery, National Cancer Center East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Minoru Sakuraba MD, PhD

Authors
  1. Kenichi Kamizono MD
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  2. Minoru Sakuraba MD, PhD
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  3. Shogo Nagamatsu MD, PhD
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  4. Shimpei Miyamoto MD, PhD
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  5. Ryuichi Hayashi MD
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Corresponding author

Correspondence to Minoru Sakuraba MD, PhD.

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Kamizono, K., Sakuraba, M., Nagamatsu, S. et al. Statistical Analysis of Surgical Site Infection After Head and Neck Reconstructive Surgery. Ann Surg Oncol 21, 1700–1705 (2014). https://doi.org/10.1245/s10434-014-3498-8

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  • DOI: https://doi.org/10.1245/s10434-014-3498-8

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