Surgical site infections in paediatric otolaryngology operative procedures

Ifeacho, Sonna; Bajaj, Yogesh; Jephson, Christopher; Albert, David

doi:10.1016/j.ijporl.2012.03.023

Cited by 7 publications

(12 citation statements)

References 22 publications

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“…8 The etiology of such infections is often secondary to auto‐contamination from a patient's native microbial flora. 7 These infections are associated with increased patient morbidity including protracted hospital courses, prolonged antibiotics, and a delay in return to baseline activity. 7 , 9 In addition, SSI are known to have a profound impact on health care costs, 10 , 11 both in low‐middle and high income countries.…”

Section: Introductionmentioning

confidence: 99%

“… 7 These infections are associated with increased patient morbidity including protracted hospital courses, prolonged antibiotics, and a delay in return to baseline activity. 7 , 9 In addition, SSI are known to have a profound impact on health care costs, 10 , 11 both in low‐middle and high income countries. 12 Composite morbidity after pediatric airway reconstruction approaches 20% and hospital‐acquired SSI develop in 6%.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis

Johnson

Teplitzky

Wynings

et al. 2022

Laryngoscope Investig Oto

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Objectives To determine the rate of surgical site infections (SSI) after pediatric open airway reconstruction using a nationwide database. Study Design Cross‐sectional study of the American College of Surgeons National Surgical Quality Improvement Program‐Pediatric (ACS NSQIP‐P) Database. Methods The ACS NSQIP‐P was queried for open airway surgeries between 2013 and 2019 determining postoperative SSI and wound dehiscence with a random sample of non‐airway cases serving as a control group. Results A total of 637 laryngotracheoplasties (LTP), 411 tracheal resections (TR) and 2100 control procedures were included. LTP and TR were both performed on younger children with more comorbidities than control surgeries ( p < .05). Postoperative wound complications occurred more often after airway reconstructions than non‐airway cases (6.4% vs. 2.9%, p < .001). Compared to non‐airway procedures, LTP (OR: 2.42, 95% CI: 1.62–3.61) and TR (OR: 2.07, 95% CI: 1.28–3.66) developed increased SSI. Multiple logistic regression identified dirty or infected wounds (OR: 4.61, p < .001, 95% CI: 2.35–9.03) and American Society of Anesthesiologists (ASA) Class IV (OR: 3.19, p = .02, 95% CI: 1.12–8.39) as the strongest predictors of SSI after airway reconstruction. Conclusions SSI after pediatric airway reconstruction occur in 6% of cases and are increased in infected wounds and ASA Class IV surgeries. Recognizing common factors for these complications provide reliable benchmarking to design surgical quality improvement initiatives. Level of Evidence 4.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis

Johnson

Teplitzky

Wynings

et al. 2022

Laryngoscope Investig Oto

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“…Postoperative Surgical site infection (SSI) in head and neck ablative surgery is related to the perioperative exposure of the wound to bacteria [1][2][3]. The source of infection is mainly made from auto-contamination of the surgical wound [4,5].…”

Section: Introductionmentioning

confidence: 99%

Mapping the Risk Factors of Pharyngocutaneous Fistula After Salvage Laryngectomies

Nassar

2021

Indian J Otolaryngol Head Neck Surg

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To evaluate the postoperative surgical wound infection prevalence rates of patients undergoing SL, identify the causative organism and determine predisposing factors leading to infection. A retrospective study of all consecutive patients who underwent salvage total laryngectomy at our unit between 2015 and 2020 was performed. The following parameters were also analyzed: age, smoking history, pre and postoperative albumin level, history of radio and chemo-radiotherapy, reconstruction with pectoralis flap, intraoperative tracheoesophageal puncture, and tumor stage. A total of 12 of the 21 patients (57%) experienced a postoperative infection after SL during the study period. 82% of those patients whose preoperative albumin level below 3gm/dl developed postoperative infection. There is a significant increase (p \ 0.01) in infection in patients with N1 and 2 stage tumor (68%) compared with the N0 stage tumors (40%). Multivariate analysis showed that preoperative albumin and nodal stage were significant risk factors for postoperative infection.

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mentioning

confidence: 99%

“…6 The source of infection is mainly attributed to autocontamination of the surgical wound. 7,8 SSI was reported to be associated with a significant increase in mortality, morbidity, and burden on the health system. 1,2,7,9,10 The latest CDC progress report 5 on health care-associated infections found a 19% decrease in SSI in 10 select procedures between 2008 and 2013: abdominal aortic aneurysm repair, peripheral vascular bypass surgery, coronary artery graft, cardiac surgery, colon surgery, rectal surgery, hip arthroplasty, abdominal hysterectomy, knee arthroplasty, and vaginal hysterectomy.…”

mentioning

confidence: 99%

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

Al‐Qurayshi

Walsh

Owen

et al. 2019

Otolaryngol.--head neck surg.

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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.

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Surgical site infections in paediatric otolaryngology operative procedures

Cited by 7 publications

References 22 publications

Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis

Surgical site infections after pediatric open airway reconstruction—A National Surgical Quality Improvement Program‐Pediatric analysis

Mapping the Risk Factors of Pharyngocutaneous Fistula After Salvage Laryngectomies

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

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