Risk factors and etiology of surgical site infection after radical neck dissection in patients with head and neck cancer.
10.3904/kjim.2016.31.1.162
- Author:
So Yeon PARK
1
;
Mi Suk KIM
;
Joong Sik EOM
;
Jin Seo LEE
;
Young Soo RHO
Author Information
1. Division of Infectious Diseases, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea. helppl@hallym.ac.kr
- Publication Type:Observational Study ; Original Article
- Keywords:
Surgical site infection;
Head and neck neoplasms;
Microbiology
- MeSH:
Aged;
Bacteriological Techniques;
Blood Loss, Surgical;
Cardiovascular Diseases/complications;
Chi-Square Distribution;
Female;
Head and Neck Neoplasms/*surgery;
Humans;
Incidence;
Logistic Models;
Male;
Medical Records;
Middle Aged;
Multivariate Analysis;
Neck Dissection/*adverse effects;
Odds Ratio;
Operative Time;
Republic of Korea;
Retrospective Studies;
Risk Factors;
Sex Factors;
Surgical Wound Infection/diagnosis/epidemiology/*microbiology;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2016;31(1):162-169
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Surgical site infection (SSI) is a major complication after radical neck dissection (RND) in patients with head and neck cancer (HNC). We investigated the incidence, risk factors, and etiology of SSI among patients who underwent RND. METHODS: A retrospective cohort study was performed on HNC patients, excluding those with thyroid cancer, who underwent first RND at a teaching hospital between January 2006 and June 2010. Medical records were collected and analyzed to evaluate the risk factors and microbiological etiologies. RESULTS: A total of 370 patients underwent first RND. The overall incidence of SSI was 19.7% (73/370). Multivariate analysis showed that male sex (odds ratio [OR], 4.281; p = 0.004), cardiovascular diseases (OR, 1.941; p = 0.020), large amount of blood loss during surgery (OR, 4.213; p = 0.001), and surgery lasting longer than 6 hours (OR, 4.213; p = 0.002) were significantly associated with SSI. The most common causative pathogen was Staphylococcus aureus (32.6%), and 93.2% of S. aureus isolates were methicillin-resistant. Klebsiella pneumoniae (13/92, 14.1%), Pseudomonas aeruginosa (11/92, 12.0%), and Enterococcus species (11/92, 12.0%) were also frequently detected. CONCLUSIONS: Based on our results, we predict that certain groups of patients are at high risk for SSIs after major HNC surgery. Preventive measures or close monitoring in these patients may be required to reduce the likelihood of postoperative SSIs. Furthermore, even though additional research is required, we would consider changing the prophylactic antibiotic regimens according to the causative organisms.
