Risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and neck surgery.
Surgical site infections can adversely affect flaps in head and neck reconstruction. The purpose of this study was to evaluate the risk factors of surgical site infections in supraclavicular artery island flap reconstructions.



Records of patients undergoing head and neck surgery from 2011 to 2014 with supraclavicular artery island flap reconstruction at a single specialty hospital were reviewed; surgical site infections ≤30 days postoperatively were noted.



Of 64 patients, 86% underwent resection for malignancy, 55% previously received radiation. Sixty-three percent of surgeries were clean-contaminated. Seven patients (11%) developed recipient site surgical site infections, all in patients who underwent clean-contaminated surgery for malignancy. There was no complete flap loss. No significant differences in demographics or perioperative factors were noted. Oral cavity and laryngeal reconstructions (p = .014) and clean-contaminated surgery (p = .04) were factors associated with increased surgical site infection risk on univariate but not multivariate analysis. Patients with surgical site infections had longer hospitalizations (p = .003).



The supraclavicular artery island flap can be used for head and neck reconstruction with a low rate of surgical site infection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. ngoyal1@hmc.psu.edu.|Penn State Milton S. Hershey Medical Center, Division of Otolaryngology Head and Neck Surgery, Hershey, Pennsylvania. ngoyal1@hmc.psu.edu.
Neerav
N
Goyal
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Kevin S
KS
Emerick
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Daniel G
DG
Deschler
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Derrick T
DT
Lin
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.|Lahey Hospital and Medical Center, Department of Otolaryngology, Burlington, Massachusetts.
Bharat B
BB
Yarlagadda
Department of Nursing, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Debbie L
DL
Rich
Massachusetts General Hospital, Division of Infectious Diseases, Boston, Massachusetts.
Marlene L
ML
Durand
D000368:Aged; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012307:Risk Factors; D013524:Surgical Flaps / Q000098:blood supply; D013530:Surgical Wound Infection / Q000209:etiology*
fistula; head and neck cancer; reconstructive surgery; supraclavicular flap; surgical site infections