title: Antibiotic prophylaxis in uncontaminated neck dissection.
abstract: OBJECTIVE
  To describe our institution's experience with antibiotic prophylaxis in uncontaminated neck dissection and to identify risk factors associated with postoperative wound infection.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Between April 2006 and June 2010, 244 patients underwent 273 uncontaminated neck dissections at a single tertiary care center. Patient factors, operative details, and postoperative complications were recorded. Patients were separated into three groups: no prophylactic antibiotics, intraoperative antibiotics only, and intra- and postoperative antibiotics.
  
  
  RESULTS
  Wound infections occurred after nine of the 273 procedures (3.3%). All of the wound infections occurred in patients receiving intraoperative antibiotics only (4 of 157) or intra- and postoperative antibiotics (5 of 75) (P = .11). The development of a wound infection was not associated with age, sex, history of tobacco and alcohol use, history of head and neck surgery, or history of radiation or chemotherapy. Wound infection was independently associated with operative time (adjusted odds ratio, 1.35; 95% confidence interval, 1.07-1.71; P = .011, for each additional hour of surgery) and with radical or extended neck dissection (adjusted odds ratio, 14.61; 95% confidence interval, 2.37-90.01, P = .004).
  
  
  CONCLUSIONS
  Our data did not support the use of antibiotic prophylaxis in routine uncontaminated neck dissection. Prophylactic antibiotics, however, may be indicated for more extensive lymphadenectomy procedures.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA. li-xing.man@uth.tmc.edu
authors.forename: Li-Xing
authors.initials: LX
authors.lastname: Man
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Beswick
authors.forename: Jonas T
authors.initials: JT
authors.lastname: Johnson
mesh_terms: D000368:Aged; D019072:Antibiotic Prophylaxis / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects / Q000379:methods*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome