Risk factors for complications in clean-contaminated head and neck surgical procedures
Background. Contamination of a head and neck surgical wound with oropharyngeal secretions has been shown to dramatically increase the incidence of wound complications. Appropriate perioperative antibiotic prophylaxis has significantly reduced contaminated wound infection rates in several previous re...
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| Veröffentlicht in: | Head & neck 1995-01, Vol.17 (1), p.7-13 |
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| creator | Girod, Douglas A. McCulloch, Timothy M. Tsue, Terance T. Weymuller Jr, Ernest A. |
| description | Background. Contamination of a head and neck surgical wound with oropharyngeal secretions has been shown to dramatically increase the incidence of wound complications. Appropriate perioperative antibiotic prophylaxis has significantly reduced contaminated wound infection rates in several previous reports. The current study examined multiple patient parameters to determine risk factors for all perioperative complications following clean‐contaminated head and neck surgical procedures.
Methods. Retrospective review of medical records from 159 patients who underwent clean‐contaminated major head and neck surgical procedures at the University of Washington between 1985 and 1991. More than 30 preoperative and operative parameters were evaluated, and all complications were recorded. The data were examined using a multivariate statistical analysis.
Results. An overall complication rate of 63% included 22% with wound infections (oro/pharyngocutaneous fistula or purulent drainage), 22% with other types of infections, and 51% with noninfectious complications. The overall perioperative mortality rate was 1.2% (two patients). Prior radiotherapy, operative time, perioperative transfusion, and flap reconstruction were all associated with a significantly higher overall complication rate (p ≤ 0.05). Only prior radiotherapy therapy correlated with an increase in wound infection rate (p = 0.05).
Conclusions. Prior radiotherapy significantly increases the risk of perioperative complications and wound infections following clean‐contaminated head and neck surgical procedures. Other factors reflecting the complexity of the procedure also influence the overall complication rate. © 1995 Jons Wiley & Sons, Inc. |
| doi_str_mv | 10.1002/hed.2880170103 |
| format | Article |
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Methods. Retrospective review of medical records from 159 patients who underwent clean‐contaminated major head and neck surgical procedures at the University of Washington between 1985 and 1991. More than 30 preoperative and operative parameters were evaluated, and all complications were recorded. The data were examined using a multivariate statistical analysis.
Results. An overall complication rate of 63% included 22% with wound infections (oro/pharyngocutaneous fistula or purulent drainage), 22% with other types of infections, and 51% with noninfectious complications. The overall perioperative mortality rate was 1.2% (two patients). Prior radiotherapy, operative time, perioperative transfusion, and flap reconstruction were all associated with a significantly higher overall complication rate (p ≤ 0.05). Only prior radiotherapy therapy correlated with an increase in wound infection rate (p = 0.05).
Conclusions. Prior radiotherapy significantly increases the risk of perioperative complications and wound infections following clean‐contaminated head and neck surgical procedures. Other factors reflecting the complexity of the procedure also influence the overall complication rate. © 1995 Jons Wiley & Sons, Inc.</description><identifier>ISSN: 1043-3074</identifier><identifier>EISSN: 1097-0347</identifier><identifier>DOI: 10.1002/hed.2880170103</identifier><identifier>PMID: 7883554</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cutaneous Fistula - etiology ; Female ; Fistula - etiology ; Head and Neck Neoplasms - radiotherapy ; Head and Neck Neoplasms - surgery ; Humans ; Male ; Mandible - surgery ; Medical sciences ; Middle Aged ; Mouth Diseases - etiology ; Multivariate Analysis ; Otorhinolaryngology (head neck, general aspects and miscellaneous) ; Otorhinolaryngology. Stomatology ; Pharyngeal Diseases - etiology ; Radiotherapy - adverse effects ; Retrospective Studies ; Risk Factors ; Suppuration ; Surgical Flaps - adverse effects ; Surgical Wound Infection - etiology ; Survival Rate ; Time Factors ; Transfusion Reaction ; Tumors</subject><ispartof>Head & neck, 1995-01, Vol.17 (1), p.7-13</ispartof><rights>Copyright © 1995 Wiley Periodicals, Inc., A Wiley Company</rights><rights>1995 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4733-6f5f68e0fab0bb9ead1bf72696c783c025b1d887d63ea1c742d703e40b9645e53</citedby><cites>FETCH-LOGICAL-c4733-6f5f68e0fab0bb9ead1bf72696c783c025b1d887d63ea1c742d703e40b9645e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhed.2880170103$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhed.2880170103$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,4010,27904,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=3469808$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7883554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Girod, Douglas A.</creatorcontrib><creatorcontrib>McCulloch, Timothy M.</creatorcontrib><creatorcontrib>Tsue, Terance T.</creatorcontrib><creatorcontrib>Weymuller Jr, Ernest A.</creatorcontrib><title>Risk factors for complications in clean-contaminated head and neck surgical procedures</title><title>Head & neck</title><addtitle>Head Neck</addtitle><description>Background. Contamination of a head and neck surgical wound with oropharyngeal secretions has been shown to dramatically increase the incidence of wound complications. Appropriate perioperative antibiotic prophylaxis has significantly reduced contaminated wound infection rates in several previous reports. The current study examined multiple patient parameters to determine risk factors for all perioperative complications following clean‐contaminated head and neck surgical procedures.
Methods. Retrospective review of medical records from 159 patients who underwent clean‐contaminated major head and neck surgical procedures at the University of Washington between 1985 and 1991. More than 30 preoperative and operative parameters were evaluated, and all complications were recorded. The data were examined using a multivariate statistical analysis.
Results. An overall complication rate of 63% included 22% with wound infections (oro/pharyngocutaneous fistula or purulent drainage), 22% with other types of infections, and 51% with noninfectious complications. The overall perioperative mortality rate was 1.2% (two patients). Prior radiotherapy, operative time, perioperative transfusion, and flap reconstruction were all associated with a significantly higher overall complication rate (p ≤ 0.05). Only prior radiotherapy therapy correlated with an increase in wound infection rate (p = 0.05).
Conclusions. Prior radiotherapy significantly increases the risk of perioperative complications and wound infections following clean‐contaminated head and neck surgical procedures. Other factors reflecting the complexity of the procedure also influence the overall complication rate. © 1995 Jons Wiley & Sons, Inc.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cutaneous Fistula - etiology</subject><subject>Female</subject><subject>Fistula - etiology</subject><subject>Head and Neck Neoplasms - radiotherapy</subject><subject>Head and Neck Neoplasms - surgery</subject><subject>Humans</subject><subject>Male</subject><subject>Mandible - surgery</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mouth Diseases - etiology</subject><subject>Multivariate Analysis</subject><subject>Otorhinolaryngology (head neck, general aspects and miscellaneous)</subject><subject>Otorhinolaryngology. Stomatology</subject><subject>Pharyngeal Diseases - etiology</subject><subject>Radiotherapy - adverse effects</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Suppuration</subject><subject>Surgical Flaps - adverse effects</subject><subject>Surgical Wound Infection - etiology</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Transfusion Reaction</subject><subject>Tumors</subject><issn>1043-3074</issn><issn>1097-0347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkEtLAzEUhYMo9bl1J2ThdurNJJNkllLrA0ShaAU3IZNJNHYeJZmi_feOTFVcuboXzvnu4yB0TGBMANKzV1uOUymBCCBAt9AegVwkQJnY_uoZTSgItov2Y3wDAMpZOkIjISXNMraH5jMfF9hp07UhYtcGbNp6WXmjO982EfsGm8rqJjFt0-naN7qzJX61usS6KXFjzQLHVXjpgQovQ2tsuQo2HqIdp6tojzb1AD1eTh8m18nt_dXN5Pw2MUxQmnCXOS4tOF1AUeT9VFI4kfKcGyGpgTQrSCmlKDm1mhjB0lIAtQyKnLPMZvQAjYe5JrQxBuvUMvhah7UioL7yUX0-6jefHjgZgOWqqHvp274JpNdPN7qO_Usu6Mb4-GOjjOcSZG_LB9u7r-z6n6Xqenrx54RkYH3s7McPq8NCcUFFpp7urtRklj7POaEK6CdXxI24</recordid><startdate>199501</startdate><enddate>199501</enddate><creator>Girod, Douglas A.</creator><creator>McCulloch, Timothy M.</creator><creator>Tsue, Terance T.</creator><creator>Weymuller Jr, Ernest A.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>John Wiley & Sons</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199501</creationdate><title>Risk factors for complications in clean-contaminated head and neck surgical procedures</title><author>Girod, Douglas A. ; McCulloch, Timothy M. ; Tsue, Terance T. ; Weymuller Jr, Ernest A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4733-6f5f68e0fab0bb9ead1bf72696c783c025b1d887d63ea1c742d703e40b9645e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cutaneous Fistula - etiology</topic><topic>Female</topic><topic>Fistula - etiology</topic><topic>Head and Neck Neoplasms - radiotherapy</topic><topic>Head and Neck Neoplasms - surgery</topic><topic>Humans</topic><topic>Male</topic><topic>Mandible - surgery</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mouth Diseases - etiology</topic><topic>Multivariate Analysis</topic><topic>Otorhinolaryngology (head neck, general aspects and miscellaneous)</topic><topic>Otorhinolaryngology. Stomatology</topic><topic>Pharyngeal Diseases - etiology</topic><topic>Radiotherapy - adverse effects</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Suppuration</topic><topic>Surgical Flaps - adverse effects</topic><topic>Surgical Wound Infection - etiology</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Transfusion Reaction</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Girod, Douglas A.</creatorcontrib><creatorcontrib>McCulloch, Timothy M.</creatorcontrib><creatorcontrib>Tsue, Terance T.</creatorcontrib><creatorcontrib>Weymuller Jr, Ernest A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Head & neck</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Girod, Douglas A.</au><au>McCulloch, Timothy M.</au><au>Tsue, Terance T.</au><au>Weymuller Jr, Ernest A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for complications in clean-contaminated head and neck surgical procedures</atitle><jtitle>Head & neck</jtitle><addtitle>Head Neck</addtitle><date>1995-01</date><risdate>1995</risdate><volume>17</volume><issue>1</issue><spage>7</spage><epage>13</epage><pages>7-13</pages><issn>1043-3074</issn><eissn>1097-0347</eissn><abstract>Background. Contamination of a head and neck surgical wound with oropharyngeal secretions has been shown to dramatically increase the incidence of wound complications. Appropriate perioperative antibiotic prophylaxis has significantly reduced contaminated wound infection rates in several previous reports. The current study examined multiple patient parameters to determine risk factors for all perioperative complications following clean‐contaminated head and neck surgical procedures.
Methods. Retrospective review of medical records from 159 patients who underwent clean‐contaminated major head and neck surgical procedures at the University of Washington between 1985 and 1991. More than 30 preoperative and operative parameters were evaluated, and all complications were recorded. The data were examined using a multivariate statistical analysis.
Results. An overall complication rate of 63% included 22% with wound infections (oro/pharyngocutaneous fistula or purulent drainage), 22% with other types of infections, and 51% with noninfectious complications. The overall perioperative mortality rate was 1.2% (two patients). Prior radiotherapy, operative time, perioperative transfusion, and flap reconstruction were all associated with a significantly higher overall complication rate (p ≤ 0.05). Only prior radiotherapy therapy correlated with an increase in wound infection rate (p = 0.05).
Conclusions. Prior radiotherapy significantly increases the risk of perioperative complications and wound infections following clean‐contaminated head and neck surgical procedures. Other factors reflecting the complexity of the procedure also influence the overall complication rate. © 1995 Jons Wiley & Sons, Inc.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>7883554</pmid><doi>10.1002/hed.2880170103</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Cutaneous Fistula - etiology Female Fistula - etiology Head and Neck Neoplasms - radiotherapy Head and Neck Neoplasms - surgery Humans Male Mandible - surgery Medical sciences Middle Aged Mouth Diseases - etiology Multivariate Analysis Otorhinolaryngology (head neck, general aspects and miscellaneous) Otorhinolaryngology. Stomatology Pharyngeal Diseases - etiology Radiotherapy - adverse effects Retrospective Studies Risk Factors Suppuration Surgical Flaps - adverse effects Surgical Wound Infection - etiology Survival Rate Time Factors Transfusion Reaction Tumors |
| title | Risk factors for complications in clean-contaminated head and neck surgical procedures |
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