[Wound healing in reconstructive head and neck surgery].
BACKGROUND
Smoking cessation and shorter operative duration are known as factors to improve wound healing in reconstructive head and neck surgery. We investigated the other factors associated with wound healing.


METHODS
Informations on age, sex, body mass index, smoking status, serum albumin level, diabetes mellitus, chronic obstructive pulmonary diseases, preoperative steroid therapy, preoperative chemotherapy, preoperative radiation therapy, preoperative starvation care, American Society of Anesthesiologists physical status (ASA-PS), intraoperative administration of prostaglandin E1, operative duration, and type of flap were obtained from the medical records of 370 patients. Requirements of postoperative intervention were also recorded. Factors associated with wound healing were estimated by multivariate analysis.


RESULTS
Compared with smokers, 22 to 42 day smoking quitters, over 43 day smoking quitters, and non-smokers had lower incidence of wound complications; odds ratio; 95% confidence intervals (CI) were 0.20; 0.06-0.68, 0.19; 0.07-0.51, and 0.15; 0.05-0.45, respectively. Other factors and odds ratios (95% CI) associated with wound complications were preoperative chemotherapy; 3.02 (1.09-8.41), preoperative starvation; 0.23 (0.06-0.84), every one minute of operation duration; 1.01 (1.00-1.01).


CONCLUSIONS
Preoperative smoking cessation, preoperative chemotherapy, preoperative starvation care, and operation duration were significantly associated with wound healings.
Kuri
Michioki
M
Department of Anesthesiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka.
Tanigami
Hironobu
H
Kambara
Noriko
N
Kishi
Yoshihiko
Y
D000368:Aged; D044964:Cervicoplasty; D017024:Chemotherapy, Adjuvant; D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010289:Parenteral Nutrition, Total; D019990:Perioperative Care; D011379:Prognosis; D012189:Retrospective Studies; D016540:Smoking Cessation; D013217:Starvation; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology*