Abstract
Surgical site infections (SSIs) constitute a major problem among patients who undergo surgery for oral cancer and remain a substantial cause of morbidity, prolonged hospitalization and death. The aim of this study was to assess the microbial spectrum of post-operative wound infections and to assess the outcome of appropriate antibiotic usage in patients who underwent surgery for oral cancer. This was a prospective observational study done in a tertiary care cancer hospital. Patients who underwent surgery for cancers of the oral cavity during the period January 2014 to December 2016 were included in the study. The spectrum of infections, risk factors, microbial profile, antibiotic susceptibility pattern, treatment given and outcome were assessed. A total of 1431 patients who underwent surgery for cancers of the oral cavity during the study period were followed up. SSIs were noticed in 118 (8%) post-operative cases. This included 55 (76.4%) incisional SSIs and 17 (23.6%) organ/space SSIs. Culture of the surgical site in 72 infected patients yielded a total of 122 isolates. Thirty patients (41.6%) had polymicrobial infections. Gram-negative bacterial isolates (70.5%) outnumbered gram-positive bacterial isolates (27%). Majority of the patients (48 patients—66.6%) were in stage IV disease. Successful management of patients with bacterial infections depends on early identification of bacterial pathogens and selection of an effective antibiotic against the organism. Judicial use of antibiotics is also very essential to prevent the development of drug resistance.
Similar content being viewed by others
References
Gregory L, Kathy F, Valerie H et al (2009) Surgical site infection: incidence and impact on hospital utilization and treatment costs. Am J Infect Control 37(5):387–397
Yao CM, Ziai H, Tsang G et al (2017) Surgical site infections following oral cavity cancer resection and reconstruction is a risk factor for plate exposure. J Otolaryngol Head Neck Surg 46:30
Horan TC, Gaynes RP, Martone WJ et al (1992) CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control 20(5):271–274
Emori TG, Gaynes RP (1993) An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 6:428–442
Durand ML, Yarlagadda BB, Rich DL et al (2015) The time course and microbiology of surgical site infections after head and neck free flap surgery. Laryngoscope 125(5):1084–1089
Goyal N, Yarlagadda BB, Deschler DG et al (2017) Surgical site infections in major head and neck surgeries involving pedicled flap reconstruction. Ann Otol Rhinol Laryngol 126:20–28
Berard F, Gandon J (1964) Postoperative wound infections: the influence of ultraviolet irradiation of the operating room and of various other factors. Ann Surg 160:1–192
Haque M, Sartelli M, McKimm J et al (2018) Health care-associated infections: an overview. Infect Drug Resist 11:2321–2333
Chaukar DA, Deshmukh AD, Majeed T et al (2013) Factors affecting wound complications in head and neck surgery: a prospective study. Indian J Med Paediatr Oncol 34:247–251
Gourin CG, Starmer HM, Herbert RJ et al (2015) Short- and long-term outcomes of laryngeal cancer care in the elderly. Laryngoscope 125:924–933
Vermeulen H, Ubbink D, Goossens A et al (2004) Dressings and topical agents for surgical wounds healing by secondary intention. Cochrane Database Syst Rev 2:CD003554
Culver DH, Horan TC, Gaynes RP et al (1991) Surgical wound infection rates by wound class, operative procedure, and patient risk index. National Nosocomial Infections Surveillance System. Am J Med 91:152S–157S
Edwards PS, Lipp A, Holmes A (2004) Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database Syst Rev 3:CD003949
Loeb MB, Main C, Eady A et al (2003) Antimicrobial drugs for treating methicillin-resistant Staphylococcus aureus colonization. Cochrane Database Syst Rev 4:CD003340
Tanner J, Norrie P, Melen K (2011) Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev 11:CD004122
Tanner J, Swarbrook S, Stuart J (2008) Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev 1:CD004288
Webster J, Osborne S (2006) Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev 2:CD004985
Magill SS, Edwards JR, Bamberg W et al (2014) Multistate point-prevalence survey of health care-associated infections. N Engl J Med 370(13):1198–1208
Spagnolo AM, Ottria G, Amicizia D et al (2013) Operating theatre quality and prevention of surgical site infections. J Prev Med Hyg 54(3):131–137
Jacobson LK, Johnson MB, Dedhia RD et al (2017) Impaired wound healing after radiation therapy: a systematic review of pathogenesis and treatment. J Plast Reconstr Aesthet 13:92–105
Shamberger RC, Devereux DF, Brennan MF (1981) The effect of chemotherapeutic agents on wound healing. Int Adv Surg Oncol 4:15–58
Odom-Forren J (2006) Preventing surgical site infections. Nursing 36:58–63
Acknowledgements
We take this opportunity to thank the faculty, fellows, post graduates and staff of the department of Head and Neck surgery and Microbiology for their whole-hearted cooperation in completion of this study.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
There is no conflict of interest pertaining to this study.
Ethical Approval
All investigations and procedures done in studies were in accordance with the ethical standards of Regional Cancer Centre, Thiruvananthapuram approved by the Institutional Ethics Committee.
Ethical Statement
There was adherence to ethical standards in this study.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Balagopal, P.G., Suresh, S., Nath, S.R. et al. Pattern of Post-Operative Infections Among Oral Cavity Cancer Patients in a Tertiary Care Cancer Centre: A Prospective Study. Indian J Otolaryngol Head Neck Surg 74 (Suppl 2), 2002–2007 (2022). https://doi.org/10.1007/s12070-020-01963-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-020-01963-1