The effect of preventive oral care on postoperative infections after head and neck cancer surgery

Abstract

This study aimed to investigate the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) in head and neck cancer (HNC) patients and clarify the relationship between oral care and postoperative infection. Methods: We conducted a retrospective observation survey based on the medical records of 209 HNC surgery patients managed at a University Hospital in 2016-2018. The incidence of PP and SSI were assessed in patients who underwent operations of the nose and paranasal sinuses to the larynx. Factors associated with PP and SSI in a univariate analysis were included in a multiple logistic regression analysis. A Cox proportional hazards model was used analyze the incidence of PP according to time after surgery. The present study was approved by the ethical review board of our Institute. Results: The rates of PP and SSI in our study population were 20.5% and 23.0%. Operative time (P < 0.01), blood loss (P = 0.004), tracheostomy (P < 0.01), reconstruction (P < 0.01), and preoperative plaque control record (PCR) (P < 0.01) were significantly associated with PP. The PCR depicted the oral hygiene based on the percentage of plaque attached to the tooth neck. A multiple logistic regression analysis indicated that the incidence of PP was significantly higher in patients with PCR values of ≥50% after preoperative oral care (OR = 10.174, 95% CI 2.14-48.32, P = 0.004). Tracheostomy (P < 0.01), reconstruction (P = 0.044), a lower preoperative albumin level (P = 0.019), and a lower preoperative hemoglobin level (P < 0.01) were significantly associated with SSI. Conclusions: The incidence of PP among patients who received oral care was high in those patients with high PCR values, indicating the importance of increasing compliance to preoperative oral care.

Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems

“…A simple, inexpensive oral hygiene regimen resulted in positive outcomes for patients with and without dysphagia in inpatient stroke rehabilitation settings (47). In addition, preoperative oral care by dentists has reduced postoperative complications in patients undergoing cancer surgery (48). Therefore, oral health management needs to be improved and integrated into the carechain of hospitalized individuals.…”

Management of Oral Hygiene in Head-Neck Cancer Patients Undergoing Oncological Surgery and Radiotherapy: A Systematic Review

“…The retrospective observational studies by Gondo et al [ 34 ] and Ishimaru et al [ 33 ] note the importance of including the patient who is to undergo resective oncologic surgery in oral care programs before and after surgery, in order to reduce postoperative infections. In addition, Ishimaru et al [ 33 ] states that patient preparation through oral prevention pathways is associated with a significant decrease in postoperative pneumonia and all-cause 30-day mortality following cancer resection.…”

Preoperative management and postoperative complications associated with transoral decompression for the upper cervical spine

“…Odontopathy, such as dental caries and gingivitis, should be treated preoperatively. Oral hygiene should be maintained preoperatively to prevent the occurrence of wound infection [ 28 ]. Nasogastric tube feeding is performed for 5–10 days postoperatively, and semiliquid feeding is arranged for the following week.…”