title: Head and neck free flap surgical site infections in the era of the Surgical Care Improvement Project.
abstract: Compliance with Surgical Care Improvement Project (SCIP) parameters regarding antibiotic prophylaxis may affect surgical site infection rates. The purpose of this study was for us to report SCIP compliance, surgical site infection rates, and risk factors in a large series of head and neck free flap surgeries.
  
  
  
  A retrospective review of 480 free flap cases was performed. Surgical site infections occurring within 30 days postoperatively were noted.
  
  
  
  Surgical site infection occurred in 13.3% of cases. Prophylaxis was given in 99.8% of cases; ampicillin-sulbactam (83%) and clindamycin (9%) were most common. Prophylaxis was "on-time" in 92.3% of cases. There were no significant associations between surgical site infection and tumor stage, American Society of Anesthesiologists (ASA) classification, tumor subsite, or flap type. Prior radiation was a risk factor for surgical site infection in patients treated for malignancy.
  
  
  
  A surgical site infection rate of 13.3% was noted. In this cohort, with a compliance rate with prophylactic antibiotic measures, prior radiation was found to be a risk factor only in patients with cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E392-E398, 2016.
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: Bharat B
authors: BB
authors: Yarlagadda
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: Daniel G
authors: DG
authors: Deschler
authors: Department of Nursing, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: Debbie L
authors: DL
authors: Rich
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: Derrick T
authors: DT
authors: Lin
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: Kevin S
authors: KS
authors: Emerick
authors: Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
authors: James W
authors: JW
authors: Rocco
authors: Infectious Disease Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.|Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts.
authors: Marlene L
authors: ML
authors: Durand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis; D058752:Free Tissue Flaps / Q000382:microbiology*; D019983:Guideline Adherence; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control; D055815:Young Adult
keywords: antibiotic prophylaxis; free flap; head and neck cancer; microvascular reconstruction; surgical site infection