title: Factors affecting wound complications in head and neck surgery: A prospective study.
abstract: BACKGROUND
  Head and neck surgeries are complex. Wound complications are associated with considerable morbidity and can result in delay in the adjuvant treatment. Identification of factors will help in formulating preventive guidelines.
  
  
  OBJECTIVE
  The aim of this study is to identify perioperative factors responsible for wound complications.
  
  
  METHODS
  Prospective study of 186 head and neck patients.
  
  
  METHODS
  Pre-operative, intraoperative and post-operative factors were recorded. Each patient was evaluated for minor and major wound complications twice daily during the hospital stay.
  
  
  METHODS
  Chi-square test was used for univariate and log regression test was used for multivariate analysis.
  
  
  RESULTS
  The overall wound complication rate was 29% with 7% major and 22% minor complications. On univariate analysis, laryngeal and hypopharyngeal location, advanced T stage, poor oral hygiene, clean-contaminated surgery, low Karnofsky performance status (KPS), flap reconstruction, blood loss more than 1000 ml, perioperative blood transfusion, duration of surgery greater than 4.3 h and post-operative hemoglobin lesser than 11 g%, post-operative tracheostomy and resection of mandible were statistical significant factors. On multivariate analysis, post-operative tracheostomy, low KPS, post-operative serum albumin less than 3.7 g/dl and duration of surgery greater than 4.3 h were significant factors.
  
  
  CONCLUSIONS
  Apart from unavoidable factors, it is essential to take care of certain factors viz nutrition, haemoglobin, oral hygiene, asepsis and repeating antibiotics in prolonged surgery.
authors.affiliation: Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Devendra A
authors.initials: DA
authors.lastname: Chaukar
authors.affiliation: Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Anuja D
authors.initials: AD
authors.lastname: Deshmukh
authors.affiliation: Joy Hospital, Mumbai, Maharashtra, India.
authors.forename: Tanveer
authors.initials: T
authors.lastname: Majeed
authors.affiliation: Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
authors.affiliation: Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Prathamesh
authors.initials: P
authors.lastname: Pai
authors.affiliation: Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Anil K
authors.initials: AK
authors.lastname: D'cruz
keywords: Head and neck cancers; risk factors; wound complications; wound infection