Tracheostomy and infection prolong length of stay in hospital after surgery for head and neck cancer: a population based study

Factors associated with complications in total laryngectomy without microvascular reconstruction

“…Postsurgical complications are associated with prolonged operative time, protracted length of hospital stay, higher mortality, and increased total hospital costs . Among commonly performed ablative head and neck surgeries, total laryngectomy is the most likely to have a postoperative complication . In this study, evaluating the impact of perioperative risk factors for patients undergoing total laryngectomy without microvascular reconstruction, over a third of the cohort (37.7%) developed a postoperative complication within 30 days of surgery.…”

“…Prolonged usage of steroids within 30 days of surgery and class III contaminated wounds are the only independent factors associated with major complications on multivariate analysis. This is likely due to an increase in serious wound infections, which may in turn increase other major complications given the need for more intensive and prolonged hospital stay . Both chronic steroid use and class III wounds are known to increase postsurgical wound infections and alter surgical healing .…”

“…Perioperative factors identified on multivariate analysis that statistically affected both overall and major complications were separately reanalyzed for the locoregional flap 1,2,9,10 Among commonly performed ablative head and neck surgeries, total laryngectomy is the most likely to have a postoperative complication. 1,11,12 In this study, evaluating the impact of perioperative risk factors for patients undergoing total laryngectomy without microvascular reconstruction, over a third of the cohort (37.7%) developed a postoperative complication within 30 days of surgery. Class III contaminated wounds, prolonged operative time, patient age, and chronic preoperative corticosteroid use were independently associated with the development of either overall or major postoperative complications.…”

“…This is likely due to an increase in serious wound infections, which may in turn increase other major complications given the need for more intensive and prolonged hospital stay. 12 Both chronic steroid use and class III wounds are known to increase postsurgical wound infections and alter surgical healing. [13][14][15] Class III contaminated wounds are defined as either a major break in sterile technique, gross spillage from the gastrointestinal tract, or acute nonpurulent inflammation.…”

Impact of skeletal muscle mass volume on surgical site infection in free flap reconstruction for oral cancer

“…An infection in a surgical wound within 30 days postoperatively is referred to as a surgical site infection (SSI). This type of infection is the leading cause of prolongation of hospital stay, higher medical expenses, and delayed chemoradiotherapy after head and neck surgery (McDevitt, Cancela Mde, Kelly, Comber, & Sharp, ; Penel et al, ). Surgery for oral cancer is defined as a clean‐contaminated surgery by the Centers for Disease Control and Prevention (CDC; Mangram, Horan, Pearson, Silver, & Jarvis, ), and reconstruction with a well‐vascularized free flap is standard treatment for a large defect after extended resection of oral cancer (Makiguchi, Yokoo, & Kurihara, ; Markiewicz et al, ; Zhang et al, ).…”