title: Risk factors of surgical site infection in patients undergoing major oncological surgery for head and neck cancer.
abstract: We assessed the risk factors associated with surgical site infection (SSI) in 697 patients who underwent major oncological surgery for head-and-neck cancer (HNC). SSIs within 30days were classified as incision, space, or leakage/fistula. Preoperative and operative risk factors for SSIs were assessed by univariate and multivariate analyses. Of these 697 patients, 128 (18.4%) had SSIs. Univariate analysis showed that SSIs were associated with tumor location, advanced tumor stage, smoking and alcohol habits, diabetes, history of prior radiotherapy or chemotherapy, anemia, hypoalbuminemia, mandible cutting, flap reconstruction, tracheotomy, clean-contaminated wounds, blood transfusion, and operation times. Multivariate analysis showed that independent risk factors for developing SSIs were oral cavity cancer (odds ratio [OR]: 6.06, 95% confidence interval [CI]: 1.209-30.378), history of prior radiotherapy (OR: 2.85, 95% CI: 1.172-6.931), tracheotomy (OR: 9.757, 95% CI: 2.609-36.491), and clean-contaminated wounds (OR: 13.953, 95% CI: 2.231-87.275). In contrast, thyroid malignancy was an independent predictor of not developing SSI (OR: 0.152, 95% CI: 0.035-0.658). High-risk patients of SSIs after major HNC surgery are predicted. Preventive measures or close monitoring in these patients may be required to reduce the likelihood of postoperative SSIs. Our data may help identify and properly manage high-risk patients.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul 138-736, South Korea.
authors.forename: Dong Hwan
authors.initials: DH
authors.lastname: Lee
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Kim
authors.forename: Soon Yuhl
authors.initials: SY
authors.lastname: Nam
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Choi
authors.forename: Jong-Lyel
authors.initials: JL
authors.lastname: Roh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000382:microbiology / Q000601:surgery*; D016001:Confidence Intervals; D005260:Female; D006258:Head and Neck Neoplasms / Q000382:microbiology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013524:Surgical Flaps / Q000009:adverse effects*; D013530:Surgical Wound Infection / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D055815:Young Adult