title: Complications after craniofacial resection for malignant tumors: are complication trends changing?
abstract: OBJECTIVE
  To determine the rate and type of complications after craniofacial resection (CFR) during the most recent 10-year period in comparison to a historic control.
  
  
  METHODS
  Patients underwent CFR in 1973-1995 ("earlier" period; n = 114) and in 1996-2005 ("later" period; n = 120) before and after a broad-spectrum antibiotic regime was used.
  
  
  RESULTS
  In the later period patients had higher rates of comorbidity, dural invasion, high-grade malignancy, and wide resections (P < 0.02). Complications were identified in 52 percent of the early and 33 percent of the later groups (P = 0.002). There was 20 percent decrease in wound complications in the later period (P < 0.0001), but not in other complications. In the earlier period, complications were evenly distributed between patients younger and older than 50 years. However, in the later period, most complications occurred among elderly patients. Multivariate analysis revealed that a broad-spectrum antibiotic regime was associated with a lower complication rate (P = 0.02).
  
  
  CONCLUSIONS
  Complication rates decreased during the last 10 years due to a decline in wound infections. Broad-spectrum antibiotic coverage probably contributed to this change.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. ziv@baseofskull.org
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.forename: Mark
authors.initials: M
authors.lastname: Bilsky
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
mesh_terms: D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D015331:Cohort Studies; D035262:Cranial Fossa, Anterior; D005153:Facial Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D019292:Skull Base Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*