title: Surgical site infections after gracilis free flap reconstruction for facial paralysis.
abstract: Compared with other free tissue transfer procedures, the gracilis free muscle transfer (GFMT) for facial reanimation is unique in that the recipient site is typically uninvolved by malignancy or infection. In this study, the authors examined the incidence, bacteriology, and outcomes of surgical site infection (SSI) after gracilis free muscle transfer for facial reanimation. From 2003 to 2011, 105 patients underwent 107 GFMT operations, with 6 SSIs. All cases of infection occurred in patients receiving clindamycin, levofloxacin, and/or cefazolin perioperatively. None of the patients who received ampicillin-sulbactam developed an SSI. Surgical site cultures grew oral flora, including α-hemolytic streptococci, Haemophilus parainfluenzae, Fusobacterium and Neisseria species, and coagulase-negative staphylococci. Notably, there were no methicillin-resistant Staphylococcus aureus (MRSA) infections. These data may have implications for the optimal perioperative antibiotic choice in facial reanimation cases. Further study is needed to determine the ideal antibiotic regimen for this category of free flap surgeries.
authors.affiliation: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA. Linda_Lee@meei.harvard.edu
authors.forename: Linda N
authors.initials: LN
authors.lastname: Lee
authors.forename: Srinivas M
authors.initials: SM
authors.lastname: Susarla
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Henstrom
authors.forename: Marc H
authors.initials: MH
authors.lastname: Hohman
authors.forename: Marlene L
authors.initials: ML
authors.lastname: Durand
authors.forename: Mack L
authors.initials: ML
authors.lastname: Cheney
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D015331:Cohort Studies; D005158:Facial Paralysis / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019651:Plastic Surgery Procedures / Q000009:adverse effects* / Q000379:methods*; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D055815:Young Adult