title: Role of culture of postoperative drainage fluid in the prediction of infection of the surgical site after major oncological operations of the head and neck.
abstract: Infection of the surgical site after major oncological operations of the head and neck increases mortality and morbidity. The aim of this prospective pilot study was to assess the efficacy of culturing the exudate from the drain after cervical neck dissection to see if it predicted such infection. We studied 40/112 patients with squamous cell cancer of the head and neck who were treated during the last two years and met our inclusion criteria. Six patients developed infections (15%). Reconstruction with pedicled rather than local or microvascular flaps, duration of operation of over 7 hours, the presence of a tracheostomy, and bilateral neck dissection were considered risk factors (p=0.01). Culture of drainage fluid on postoperative day 3 that grew no pathogens predicted that the site would not become infected, with a negative predictive value of 96%.
authors.affiliation: Oral and Maxillofacial Surgery Department, Reina Sofia Universitary Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain. Electronic address: dr.candaualvarez@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Candau-Alvarez
authors.affiliation: Microbiology Department, Reina Sofia Universitary Hospital, Faculty of Medicine, Av. Menendez Pidal s/n, 14004 Cordoba, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Linares-Sicilia
authors.affiliation: Oral and Maxillofacial Surgery Department, Reina Sofia Universitary Hospital, Av. Menendez Pidal s/n, 14004 Cordoba, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Dean-Ferrer
authors.affiliation: Research Department, Division of Inflammation and Metabolism, IMIBIC, University of Cordoba, Av. Menendez Pidal s/n, 14004, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Pérez-Navero
mesh_terms: D001419:Bacteria / Q000145:classification*; D001431:Bacteriological Techniques; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004322:Drainage / Q000379:methods*; D005122:Exudates and Transudates / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D037981:Neck Dissection / Q000379:methods; D061646:Operative Time; D010865:Pilot Projects; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013524:Surgical Flaps / Q000145:classification / Q000637:transplantation; D013530:Surgical Wound Infection / Q000209:etiology*; D014139:Tracheostomy / Q000379:methods
keywords: Drainage; Microbiology; Oral cancer; Prognosis; Screening; Surgical wound infection