title: Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures.
abstract: The goal of this prospective study was to determine risk factors for wound infections (WI) for patients with head and neck cancer who had undergone surgical procedures with opening of upper aerodigestive tract mucosa in multimodal therapeutic approaches. Two hundred and sixty consecutive surgical procedures were studied at Oscar Lambret Cancer Center over a 36-month period. Twenty-five variables were recorded for each patient. Statistical evaluation used chi2 test analysis (categorical data) and Mann-Whitney test (continuous variables). Multivariate analysis was performed with logistic regression model. The overall rate of WI was 45% (117/260). Univariate analysis indicated that five variables were significantly related to the likelihood of WI: male sex (p = 0.03), previous chemotherapy (p = 0.009), duration of previous hospital stay (p = 0.013), hypopharyngeal location (p = 0.003), post-laryngectomy tracheostoma (p < 0.001). Multivariate analysis identified only one major risk factor for WI: post-laryngectomy tracheostoma (Odd Ratio 1.9 [95% CI 1.3-3]; 33% versus 64%; p = 0.001). Despite antibiotic prophylaxis, WI occurrence is high. This study identified one major risk factor, post-laryngectomy tracheostomy. Long-term curative antibiotherapy must be evaluated in cancer head and neck surgery requiring post-laryngectomy tracheostoma.
authors.affiliation: General Oncology Department, Centre Oscar Lambret, 3, rue F Combemale 59020 Lille, France; Hygiene Unit, Centre Oscar Lambret, Lille, France. n-penel@o-lambret.fr
authors.forename: Nicolas
authors.initials: N
authors.lastname: Penel
authors.forename: Charles
authors.initials: C
authors.lastname: Fournier
authors.forename: Danièle
authors.initials: D
authors.lastname: Lefebvre
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Lefebvre
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007013:Hypopharynx / Q000601:surgery; D007825:Laryngectomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012137:Respiratory System / Q000601:surgery*; D012307:Risk Factors; D012737:Sex Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D014139:Tracheostomy