Prevention of surgical site infection after oral cancer surgery by topical tetracycline: Results of a multicenter randomized control trial.

Funahara, Madoka; Yanamoto, Souichi; Suzuki, Takatsugu; Ota, Yoshihide; Nishimaki, Fumihiro; Kitamura, Hiroshi; Yamakawa, Nobuhiro; Kirita, Tadaaki; Okura, Masaya; Mekaru, Yasuaki; Arakaki, Keiichi; Umeda, Masahiro

doi:10.1200/jco.2018.36.15_suppl.6080

Cited by 6 publications

(6 citation statements)

References 14 publications

(37 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many species of indigenous bacteria are present in the oral cavity 7) , and exposing the neck surgical field to them is a risk factor for postoperative infection. Earlier studies have reported the incidence of SSIs to be 21.3% and 36.1%, showing no significant difference to that observed in the present study 3,8) .…”

Section: Discussioncontrasting

confidence: 90%

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

Iwamoto

Morikawa

Narita

et al. 2020

Bull. Tokyo Dent. Coll.

View full text Add to dashboard Cite

During dissection for oral cancer, there is a high probability of bacteria indigenous to the oral cavity migrating to the surgical field in the neck due to the opening of new pathways of communication with the oral cavity. The risk of postoperative surgical site infection (SSI) in such patients is high due to malnutrition arising from perioperative eating disorders and dysphagia. Neck infections after neck dissection in oral cancer patients were investigated to elucidate the development of SSIs and their relationship with the results of bacterial culture.A total of 86 patients with oral squamous cell carcinoma who underwent neck dissection between January 2012 and December 2016 were enrolled. Ten factors were selected for investigation: (1) sex; (2) age; (3) primary site; (4) type of dissection; (5) whether or not there was a new pathway of communication between the oral cavity and the neck; (6) operative time; (7) blood loss; (8) number of drainage days; (9) amount of drainage at the time of drain removal; and (10) whether or not there was an SSI. Bacteria isolated from the catheter tip on drain removal were also investigated. Significant differences were observed between patients with and without SSIs (p-0.010) according to the presence of a new pathway of communication between the oral cavity and the neck (p-0.004); operative time (p-0.007); number of drainage days (p-0.029); or the amount of drainage at the time of drain removal. The present results indicate that selecting antibiotics appropriate to each patient and administering perioperative oral care are important in preventing SSIs.

show abstract

Section: Discussioncontrasting

confidence: 90%

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

Iwamoto

Morikawa

Narita

et al. 2020

Bull. Tokyo Dent. Coll.

View full text Add to dashboard Cite

show abstract

“…Hayashida et al [14] reported that irrigation with tap water reduces oral bacteria in ventilated patients, but the number of bacteria in oropharyngeal fluid increased within 3 h after irrigation. Funahara et al described that topical tetracycline ointment on the tongue reduces the number of bacteria in oropharyngeal fluid for about 6 h [16]; furthermore, in a multicenter randomized clinical trial, topical application of tetracycline ointment on the tongue every 6 h for 24 h after surgery significantly prevented surgical site infection in patients undergoing oral cancer surgery with flap reconstruction and tracheotomy [17]. Some studies have investigated the effects of oral decontamination on VAP prevention.…”

Section: Discussionmentioning

confidence: 99%

Topical povidone iodine inhibits bacterial growth in the oral cavity of patients on mechanical ventilation: a randomized controlled study

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Topical 0.12% chlorhexidine has been used widely to prevent ventilator-associated pneumonia in patients undergoing mechanical ventilation. However, it is not approved for mucosal application in Japan. The aims of this study were to investigate if topical povidone iodine (i) inhibits bacterial growth and (ii) disrupts the balance of the oral microbiota. Methods: This randomized controlled clinical trial included 23 patients who underwent mechanical ventilation in the intensive care unit. The patients were divided randomly into two groups: the intervention group (n = 16) and the control group (n = 7). All patients received oral cleaning with 3% hydrogen peroxide, followed by irrigation with tap water. The patients in the intervention group received 10% povidone iodine applied topically to the oral cavity. The concentration of total bacteria in the oropharyngeal fluid were determined before, immediately after, 1 h, 2 h, and 3 h after oral care using the Rapid Oral Bacteria Quantification System, which is based on dielectrophoresis and impedance measurements. The number of streptococci, methicillin-resistant Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, Porphyromonas gingivalis, and Candida albicans before, immediately after, 1 h, and 3 h after oral care were estimated based on real-time polymerase chain reaction data. Results: After irrigation of the oral cavity, the number of bacteria decreased, but increased again at 1 h after oral care in the control group; however, in the intervention group, the concentration of bacteria was significantly lower than that in the control group at 1 hour (p = 0.009), 2 h (p = 0.001), and 3 h (p = 0.001) after oral care. The growth of all bacterial species tested was inhibited in the intervention group at 3 h after oral care, suggesting that povidone iodine did not disturb the balance of the oral microbiota.Conclusions: Topical application of povidone iodine after cleaning and irrigation of the oral cavity inhibited bacterial growth in the oropharyngeal fluid of patients on mechanical ventilation while not disrupting the balance of the oral microbiota.

show abstract

“…Multiple studies investigated risk factors of SSI by examining variable sets of factors for their potential association with infection; however, some those factors lacked reproducibility. Risk factors previously reported in literature include the following: the presence of comorbidities, 25,27 tobacco use, 8 prior radiotherapy, 9,20 prior chemotherapy, 23 type of surgery, 23,25 clean-contaminated procedures, 9,20 not using prophylactic antibiotic for cleancontaminated procedures, 28,29 longer surgery, 22,27,30 flap reconstruction, 8 neck dissection, 31,32 tracheotomy, 9,18,31 high American Society of Anesthesiologists score, 22 blood loss, 23,27 presence of lymph node metastasis, 8,25 management of a recurrent disease, 18,21 oral cavity cancer as opposed to other head and neck cancers, 9 the inflammatory state of the ear at the time of surgery, 33 preoperative high liver function tests, 6 preoperative low sodium levels, 6 and early postoperative hypoalbuminemia. 34 The study also examined risk factors of readmission with SSI and identified the following independent predictors: 1 comorbidities, history of chemotherapy, cancer diagnosis, site and class of surgery, and neck dissection.…”

Section: Discussionmentioning

confidence: 99%

Surgical Site Infection in Head and Neck Surgery: A National Perspective

Al‐Qurayshi

Walsh

Owen

et al. 2019

Otolaryngol.--head neck surg.

View full text Add to dashboard Cite

Objectives To examine trend, prevalence, and outcomes of surgical site infection (SSI) in head and neck surgery. Study Design Retrospective cross-sectional analysis. Setting The Nationwide Readmissions Database (2010-2014), which represents 56.6% of all US hospitalization. Subjects Adult patients (≥18 years) who underwent head and neck surgery. Patients with SSI were compared with controls. Methods Analysis included chi-square test and multivariate logistic and linear regression models. Results A total of 427 cases and 116,921 controls were identified. SSI prevalence among patients who underwent head and neck surgery was 0.37%, of which 41.0% was reported within the initial admission while the remaining 59.0% was reported on readmission within 30 days of first surgery. SSI was associated with a higher mortality risk (odds ratio, 3.95; 95% CI, 1.25-12.50; P = .019). Multivariate analysis demonstrated that a higher risk of SSI was associated with major surgery of the ear, nose and paranasal sinuses, mouth and tonsil, salivary glands and ducts, maxillofacial bones and mandible, and pharynx and larynx ( P < .05 each). However, a lower risk of SSI was reported in thyroid and parathyroid and nonmajor procedures ( P < .05 each). Other factors associated with a higher risk of SSI included multiple comorbidities, smoking, cancer diagnosis, concomitant neck dissection, and tracheostomy ( P < .05 each). SSI was associated with a mean ± SE additional hospital stay of 8.1 ± 0.8 days per case ( P < .001) and an additional cost on the health system of $20,953.00 ± $186.3 per case ( P < .001). Conclusions SSI is associated with a significant mortality risk and burden on the health system. More than half of SSI cases were identified on readmission.

show abstract

Prevention of surgical site infection after oral cancer surgery by topical tetracycline: Results of a multicenter randomized control trial.

Cited by 6 publications

References 14 publications

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

Investigation of Surgical Site Infections and Bacteria Detected Following Neck Dissection in Patients with Oral Cancer

Topical povidone iodine inhibits bacterial growth in the oral cavity of patients on mechanical ventilation: a randomized controlled study

Surgical Site Infection in Head and Neck Surgery: A National Perspective

Contact Info

Product

Resources

About