Multivariate analysis of risk factors for postoperative wound infection following oral and oropharyngeal cancer surgery

Belušić-Gobić, Margita; Zubovic, A; Cerović, Robert; Dekanić, Andrea; Maržić, Diana; Zamolo, Gordana

doi:10.1016/j.jcms.2017.11.003

Cited by 15 publications

(15 citation statements)

References 26 publications

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“…Few other authors have also demonstrated similar findings . Another retrospective study on 195 patients undergoing treatment for oral and oropharyngeal cancers reported that patients undergoing neck dissection had a 13 times higher odds ratio of wound complication . In our study, patients undergoing bilateral neck dissection developed more OCFs in comparison to patients undergoing unilateral neck dissection (23% vs 6%).…”

Section: Discussionmentioning

confidence: 99%

“…This may, however, only reflect the fact that tracheostomies were more often done following resection for tongue/FOM cancer as compared to BM/GBS cancer (87% vs 64%) than as a predisposing factor independently. Literature, however, shows that the presence of tracheostomy is of the risk factors for developing postoperative wound complications and fistula (PCF) formation …”

Section: Discussionmentioning

confidence: 99%

“…Literature, however, shows that the presence of tracheostomy is of the risk factors for developing postoperative wound complications and fistula (PCF) formation. 7,12,13,22 SSI is another important risk factor for fistula formation. 12 Faulty surgical techniques, prolonged duration of surgery, poor nutritional status, poor oral hygiene, type of reconstruction are some of the predisposing factors for SSI and concomitantly for PCF.…”

Section: Treatment-related Factorsmentioning

confidence: 99%

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Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: Experience from a tertiary cancer center

et al. 2019

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Background Orocutaneous fistula (OCF) is one of the frequently encountered postoperative complications following surgery for oral cancer, leading to prolonged hospital stay and delay in the initiation of adjuvant therapy. Methods We included all patients with oral cancer operated between January 2016 to December 2017 and at risk to develop an OCF. We assessed the incidence of OCF, its management, and factors predisposing to its development. Results Of 587 eligible patients, 9% developed OCF. On univariate and multivariate analysis, patients undergoing bilateral neck dissection or with surgical site infection (SSI) (P < .001) were at maximum risk. On univariate analysis, the incidence was higher following resections for tongue‐floor of mouth sub site (P = .002), irrespective of the type of flap used for reconstruction. Majority (57%) required surgical intervention for management. Conclusion The presence of SSI and performing bilateral neck dissection posed the maximum risk for developing OCF in patients undergoing surgery for oral cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Treatment-related Factorsmentioning

confidence: 99%

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Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: Experience from a tertiary cancer center

et al. 2019

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“…Causes of SSI and pneumonia are poorly understood and have not been well studied. Prior reports are limited by small sample size, 2,3,5 lack of proper definition of SSI, 5,6 and highly variable antibiotic regimes within the study population 6,7 . Many have concentrated on only one variable, that is, perioperative antibiotic prophylaxis, but still document SSI rates of approximately 21% in the “intervention” or “better” antibiotic arm 8,9 .…”

Section: Introductionmentioning

confidence: 99%

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

Karthik

Dhiwakar

2021

Head & Neck

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Background To identify risk factors for surgical site infection (SSI) and pneumonia following oral cavity tumor surgery. Methods Retrospective chart review of a consecutive series of patients undergoing oral cavity resection. Several clinicopathologic variables were tested for their association with SSI and pneumonia. Results Three hundred and forty‐four cases in 330 patients were included. Incidence of SSI and pneumonia was 67 (19.5%) and 38 (11%), respectively. On multivariate analysis, marginal mandibulectomy and segmental mandibulectomy were independent risk factors for SSI, whereas time under anesthesia (TUA) was an independent risk factor for pneumonia. Receiver operating characteristic curve identified 390 min as the cutoff above which pneumonia was predicted with a high degree of accuracy. Conclusions In oral cavity resections, mandibulectomy predisposes to SSI. Further, prolonged TUA (>390 min) is a powerful predictor for pneumonia. As it is a modifiable risk factor, reduction in TUA might correspondingly lower the incidence of postoperative pneumonia.

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“…Moreover, immunocompromised individuals demonstrate few clinical signs in bacterial infections, which are commonly confused with the symptoms of the underlying neoplasm or treatment side effects [7,10,11]. Other risk factors that contribute to poor prognosis infections in cancer patients are myeloablative therapy, total body irradiation, high doses of steroids, tissue grafting, prolonged hospitalization, recent surgery, resection of multiple organs, exposed cancer, enteral diet, ostomies, admission to intensive care unit (ICUs), presence of central venous catheter, bladder catheterization, ventilatory assistance, hemodialysis and disease chronic pulmonary disease [12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

First Insights into Clinical and Resistance Features of Infections by Klebsiella pneumoniae among Oncological Patients from a Referral Center in Amazon Region, Brazil

Santos

Rodrigues

Melo

et al. 2020

Infectious Disease Reports

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Klebsiella pneumoniae appears as one of the most prevalent pathogens among cancer patients. The present study investigates the clinical, epidemiological and microbiological aspects related to infections caused by K. pneumoniae in cancer patients treated at an oncology referral center in the state of Pará, Amazon region, Brazil. Between July 2017 to July 2019, an epidemiological, observational, cross-sectional study, with a descriptive and analytical approach was conducted, including patients with confirmed diagnosis of cancer who acquired infection by K. pneumoniae 72 h after hospital admission. K. pneumoniae isolates included in the study were obtained from different clinical materials (blood, urine, catheter tip and bladder catheter, orotracheal secretions, oncological and surgical wounds). Antimicrobial susceptibility testing and molecular detection of the carbapenemase-encoding genes were performed. A high prevalence of MDR K. pneumoniae isolates was observed, including two colistin-resistant isolates and seven isolates harboring blaKPC-1 gene. To conclude, our findings provide the firsts insights into the epidemiology and infection by K. pneumoniae in the state of Pará, Brazil, and may be useful on treatment guidance and establishment of strategies to control the spread of resistance strains of K. pneumoniae in the region.

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Multivariate analysis of risk factors for postoperative wound infection following oral and oropharyngeal cancer surgery

Cited by 15 publications

References 26 publications

Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: Experience from a tertiary cancer center

Factors predisposing to the development of orocutaneous fistula following surgery for oral cancer: Experience from a tertiary cancer center

Predictors of surgical site infection and pneumonia following oral cavity tumor surgery

First Insights into Clinical and Resistance Features of Infections by Klebsiella pneumoniae among Oncological Patients from a Referral Center in Amazon Region, Brazil

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