Cephazolin and metronidazole prophylaxis in head and neck surgery

Strauss, Melvin; Saccogna, Phillip W.; Allphin, Allan L.

doi:10.1017/s0022215100138162

Cited by 14 publications

(20 citation statements)

References 14 publications

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“…Some surgeons consider previous tracheotomy a risk factor for the development of wound infection after head and neck surgery procedures. 3,8 In our study group, 31.5 per cent of patients had a tracheotomy or permanent stoma, which suggests that previous tracheotomy is not an important factor in the development of post-operative wound infection.…”

Section: Discussionmentioning

confidence: 59%

Antibiotic prophylaxis in clean neck dissections

2004

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This study was designed to evaluate the effects of a prophylactic antibiotic regimen on the incidence of wound infection after clean neck dissections. A prospective series of 57 patients undergoing clean neck dissections with the use of perioperative ampicillin-sulbactam for 24 hours was compared with an historical control group of 51 patients undergoing clean neck dissections with no perioperative antibiotic use. The outcome variable was the incidence of post-operative wound infection. The two groups were similar for factors reported to influence the rate of post-operative wound infection. Wound infection occurred in one patient (1.7 per cent) in the study group and in seven patients (13.3 per cent) in the control group, the difference was statistically significant (p = 0.02). These data suggest that the use of a perioperative antibiotic for 24 hours in patients undergoing clean neck dissection results in significant reduction in the incidence of post-operative wound infection.

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Section: Discussionmentioning

confidence: 59%

Antibiotic prophylaxis in clean neck dissections

2004

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“…However, there is still a high degree of variability in the implementation of peri-operative antibiotic prophylaxis. Given the greater risk of SSI in free flap reconstructions [9][10][11] and the potential highly morbid consequences of infection, many clinicians use antibiotics in an effort to prevent complications. Still, data attesting to the value of this practice are lacking.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical site infection (SSI), one of the most common complications, may lead to vessel thrombosis and, eventually, to flap loss [6]. Moreover, reconstruction with free flaps is a significant risk factor for SSI in clean-contaminated head and neck operations [9][10][11]. Therefore, there has been great interest in determining the optimal regimen for antibiotic prophylaxis in the peri-operative period.…”

mentioning

confidence: 99%

Antibiotic Use after Free Tissue Reconstruction of Head and Neck Defects: Short Course vs. Long Course

Khariwala

Pierce

et al. 2016

Surgical Infections

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Background: Free tissue reconstruction has become the standard of care for most major defects in the head and neck. Surgical site infection (SSI) can lead to vessel thrombosis and eventual flap loss. The use of antibiotics after free tissue reconstruction has not been studied in the current environment of heightened bacterial antibiotic resistance. We compared the use of short-term and longer-term antibiotics in a series of patients receiving free tissue reconstructions. Methods: A retrospective review was performed of 147 patients receiving 149 free flaps who were treated with either short-course (£2 d; n = 149 [43%]) or long-course (>2 d; n = 85 [57%])) post-operative antibiotics from 2009 to 2014. The outcomes examined were infection, return to the operating room, length of hospital stay, and patient death up to six weeks post-surgery. In addition, risk factors associated with SSI were explored. Results: Surgical site infection, flap dehiscence, flap loss, and length of stay were not different in the two groups. However, those receiving long-course antibiotics had a significantly higher rate of pneumonia (24.7% vs. 10.9%; p = 0.03), although they had a lower rate of urinary tract infection (0.0% vs 9.4%, respectively; p = 0.01). Body mass index remained a statistically significant risk factor in the multivariable analysis (p = 0.005). Conclusion: Prolonged antibiotic use after free flap reconstruction of head and neck defects does not appear to prevent SSI better than short-course treatment in this population. Moreover, long-course antibiotic use was associated with a higher risk of pneumonia.

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“…The hospital course, including length of hospitalization before operation, duration of antimicrobial use before operation, length of operation, presence of implants, and previous tracheotomy can also affect postoperative SSI rates. 496,497,[501][502][503][504]508 In patients with cancer, preoperative radiation and chemotherapy as well as the stage of the malignancy may also affect infection risk. 497,498,[502][503][504] Procedure-related risk factors for infection include radical or bilateral neck dissections 501,508 and reconstruction with myocutaneous flaps or microvascular-free flaps.…”

Section: Head and Neck Proceduresmentioning

confidence: 99%