Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery: A Systematic Review and Meta-Analysis

Poorten, Vincent Vander; Uyttebroek, Saartje; Robbins, K. Thomas; Rodrigo, Juan P.; Bree, Remco de; Laenen, Annouschka; Saba, Nabil F.; Suárez, Carlos; Mäkitie, Antti; Rinaldo, Alessandra; Ferlito, Alfio

doi:10.1007/s12325-020-01269-2

Cited by 39 publications

(52 citation statements)

References 54 publications

(177 reference statements)

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“…Unlike many previous reports that included nonoral cavity sites, 1,5,7–10 highly variable antibiotic regimes, 6,7 or lacked explicit data on prophylactic antibiotics, 21 thereby introducing heterogeneity and/or bias, the current study examined a large sample of oral cavity resections that received a relatively standardized, uniform perioperative antibiotic regime. A broad spectrum of variables was examined for association with infective complications.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

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

Karthik

Dhiwakar

2021

Head & Neck

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“…The results of our study showed a non-significant reduction in SSIs as a function of the administration of adequate antibiotic prophylaxis. There is some controversy between studies that show this relationship 25 , 26 and others that do not show the efficacy of antibiotic prophylaxis 27 , although a recent systematic review by Vander Porten et al 28 concludes that the administration of antibiotic prophylaxis clearly reduces the incidence of SSIs in clean-contaminated surgery.…”

Section: Discussionmentioning

confidence: 99%

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

Alonso-García

Toledano-Muñoz

Aparicio-Fernández

et al. 2021

Sci Rep

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Health care-related infections are frequent and among them surgical site infection (SSI) are the most frequent in hospitals. The objective was to evaluate the adequacy of antibiotic prophylaxis in patients undergoing neck surgery and its relationship with the incidence of surgical site infection (SSI). Prospective cohort study. The adequacy of antibiotic prophylaxis in patients undergoing neck surgery was evaluated. Antibiotic prophylaxis was considered adequate when it conformed to all items of the protocol (antibiotic used, time of administration, administration route, dose and duration). The cumulative incidence of SSI was calculated, and the relationship between SSI and antibiotic prophylaxis adequacy was determined using adjusted relative risk (RR). Antibiotic prophylaxis was administered in 63 patients and was adequate in 85.7% (95% CI 75.0–92.3) of them. The cumulative incidence of SSI was 6.4% (95% CI 3.4–11.8). There was no significant relationship between antibiotic prophylaxis inadequacy and the incidence of SSI (RR = 2.4, 95% CI 0.6–10.6). Adequacy of antibiotic prophylaxis was high and it did not affect the incidence of SSIs.

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“…Infections associated with implantation of biomaterials are an unwanted complication of reconstructive surgery, often resulting in prolonged hospitalization, morphological and functional impairment [46]. Perioperative antibiotic prophylaxis leads to a decrease in the rate of infections associated with the implants but does not eradicate them [47][48][49][50]. Moreover, the implantation of biomaterials affects the host's innate local response and may increase the risk of infection [51].…”

Section: Discussionmentioning

confidence: 99%

New Antimicrobial Biomaterials for the Reconstruction of Craniofacial Bone Defects

et al. 2020

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Reconstructive bone surgery of the head and neck could prove challenging in terms of postoperative healing and recovery. Fighting infection during the healing period is one of the critical factors of the long-term survival of an implant. The aim of the study was to develop an innovative composition suitable for an antibacterial craniofacial implant that should have the capacity to continuously and constantly release the amount of gentamicin necessary to prevent the post-surgical infections. For this purpose, a series of composite materials based on dimethacrylic monomers, hydroxyapatite and ZrO2, with (series B) or without the addition of polymethyl methacrylate (series A), reinforced with woven E-glass fibers (FRC) were obtained using the laminate lay-up process. Gentamicin was included in all FRC sample matrices to confer an antimicrobial effect. The results show that after extraction of the residual monomers from the FRC samples in different solvents (chloroform, acetone and ethyl alcohol), the cumulative amount of released gentamicin after 12 days was between 7.05–11.38 mg for A samples and 11.21–14.52 mg for B samples. The microbiological protocol showed that gentamicin induces a two weeks-lasting antimicrobial effect maintained over the minimal inhibitory concentration for P. aeruginosa and S. aureus.

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Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery: A Systematic Review and Meta-Analysis

Cited by 39 publications

References 54 publications

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

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

Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery

New Antimicrobial Biomaterials for the Reconstruction of Craniofacial Bone Defects

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