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

Karthik, Konagalla; Dhiwakar, Muthuswamy

doi:10.1002/hed.26799

Cited by 6 publications

(7 citation statements)

References 24 publications

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“…In all subjects, watertight suture between the SP and recipient mucosa/skin was achieved. Perioperative care was predefined and standardized 14 …”

Section: Methodsmentioning

confidence: 99%

Distal positioning of the skin paddle of pectoralis major myocutaneous flap in head and neck reconstruction

Dhiwakar,

Shanmugam,

Khan

et al. 2023

Head & Neck

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BackgroundTo assess outcomes of pectoralis major myocutaneous flap (PMF) wherein the skin paddle (SP) was positioned with its distal portion extending beyond the lower border of pectoralis major by ≥2 cm (PMF‐d).MethodsConsecutive head and neck reconstructions with PMF‐d (n = 110). SP dimensions l2 (distal extent below the lower border of pectoralis major), l1 (proximal extent above lower border of pectoralis major), and b (breadth) were recorded. Endpoints were SP necrosis, recipient dehiscence, early fistula, and persistent fistula.ResultsMedian values of l2, l1, and b were 3.0, 6.0, and 6.0 cm, respectively. When l2 = 2.0–3.0 cm, SP necrosis occurred in only one (1%) subject (with obesity). When l2 was ≥3.5 cm, necrosis occurred in four (16%) subjects, three of whom also had l1/l2 < 2.0 (proximal SP < 67% of entire SP). Statistically, increased l2 was the only risk factor for necrosis (p = 0.001). Overall, incidence of recipient dehiscence, early fistula, and persistent fistula were 32 (29%), 20 (20%), and 3 (3%), respectively. Persistent fistula occurred only in the setting of SP necrosis and/or re‐irradiation.ConclusionCareful patient selection, adequate proximal SP, and l2 = 2.0–3.0 cm is associated with a negligible risk of necrosis. The enhanced reach and laxity and additional skin surface area and soft tissue volume conferred with PMF‐d facilitate recipient wound healing.

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“…In all subjects, watertight suture between the SP and recipient mucosa/skin was achieved. Perioperative care was predefined and standardized 14 …”

Section: Methodsmentioning

confidence: 99%

Distal positioning of the skin paddle of pectoralis major myocutaneous flap in head and neck reconstruction

Dhiwakar,

Shanmugam,

Khan

et al. 2023

Head & Neck

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“…SSI was regarded as the occurrence of purulent drainage or an incision that spontaneously dehisces in a patient with fever and/or localized pain or tenderness or deep site infection detected by radiographic examination within 30 days after surgery ( 2 ).…”

Section: Methodsmentioning

confidence: 99%

“…Squamous cell carcinoma (SCC) in the tongue/floor of the mouth (TFOM), whose features include lymph node metastasis and local invasion, is the most common malignancy in the oral cavity. At the initial diagnosis, the majority of these tumors have an advanced stage ( 1 , 2 ). Extensive soft or bone tissue resection is required, and free flap reconstruction is generally the preferred method ( 3 ); however, postoperative complications may develop frequently ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Yuan

et al. 2022

Front. Oncol.

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ObjectivesTo explore the possible risk factors of orocutaneous fistula (OCF) development in free flap reconstruction of the tongue/floor of the mouth (TFOM).MethodsData of patients who underwent free flap reconstruction of the TFOM were retrospectively analyzed. The association between clinicopathologic variables and OCF occurrence was analyzed using univariate and multivariate analyses.ResultsAltogether, 469 patients were enrolled. OCF occurred in 43 patients with a rate of 9.2%. The univariate analysis revealed the negative effects of smoking, preoperative albumin level, cachexia, T4 stage, neck dissection, entire resection of the floor of the mouth (FOM), segmental mandibulectomy, and surgical site infection on OCF occurrence. The multivariate analysis confirmed the independence of cachexia (p<0.001, 4.386[1.883–9.472]), tumor stage (p<0.001, 2.738[1.482–6.629]), entire FOM resection (p<0.001, 6.332[2.110–14.432]), and surgical site infection (p<0.001, 5.376[1.998–11.218]) in affecting the OCF development.ConclusionsOCF development following free flap reconstruction of the TFOM was relatively uncommon, but significantly associated with presence of cachexia, T4 stage, entire FOM resection, and surgical site infection.

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“…In order to eradicate illness in close to or entering bone, mandibulectomy was recommended for a considerable number of buccal and to a lower extent tongue primary tumour. As a result, mandibulectomy should be designated a specific subset of oral cavity surgical resection that frequently covers many subsites (18). Surgical infection is one of the most serious complications following head and neck surgery of the tumour free-flap reconstructive, which accounts for more than 40% of all cases.…”

Section: Complicationsmentioning

confidence: 99%

Types, Causes and Complication Rates of Surgical Site Infection Post Maxillofacial Surgery

Bukhsh¹,

Azhar²,

Bazaid³

et al. 2022

JOHS

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Surgical site infection is a common post-operative complication that is encountered by surgeons and is associated with notable morbidity and mortality. Oral cavity due to the presence of bacteria is more prone to infection and diseases. Even performance under complete sterilization cannot prevent the infection in oral surgeries and the prevalence of infection rate accounts to approximately 10%-15%. Post-operatively oral and maxillofacial surgeries have increased chances of infection due to bacterial load and access to incision site during healing time. The purpose of this research is to review the available information about the types, causes and complication rates of surgical site infection post maxillofacial surgery. Various procedure and patient related factors in oral and maxillofacial surgery contribute to surgical site infections. Procedure's duration and invasiveness as well as bone equipment, biomaterial use, surgical technique, and sterilization practices are some of determinants of surgical site infection. Cellulitis, abscess, maxillary sinusitis, and osteomyelitis are all common postoperative infections. Surgical site infections often result in requirement of additional treatment procedures, prolongs the hospital stay and also negatively affects health of the patient. Efficient interventions by the oral and maxillofacial surgery teams can play a vital role in prevention of such infections. Although surgical site infection is an area of concern for oral and maxillofacial surgeons’ literature on this aspect is quite scarce and very limited studies are available. In future, more clinical and comprehensive research can be beneficial.

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

Cited by 6 publications

References 24 publications

Distal positioning of the skin paddle of pectoralis major myocutaneous flap in head and neck reconstruction

Distal positioning of the skin paddle of pectoralis major myocutaneous flap in head and neck reconstruction

Predictors predisposing to orocutaneous fistula occurrence following free flap reconstruction

Types, Causes and Complication Rates of Surgical Site Infection Post Maxillofacial Surgery

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