Prevention of Oral Candidiasis After Free Flap Surgery: Role of 3% Sodium Bicarbonate Saline in Oral Care.
OBJECTIVE
Relevant reports about oral candidiasis status and prevention measures after free flap surgery for the oral and maxillofacial region are limited. The present study explored oral candidiasis status after free flap surgery and its prevention through a prospective comparative study.


METHODS
One hundred four patients were randomized to a control group (n = 54) and an experimental group (n = 50). Compared with the control group, the experimental group was provided an additional 3% sodium bicarbonate saline solution for oral care after free flap surgery. The incidence of oral candidiasis was evaluated by objective examination (saliva culture and salivary pH measurement) and subjective evaluation (clinical signs of oral candidiasis) at admission and from postoperative days 1 to 14.


RESULTS
The salivary pH values of the 2 groups were lower than the normal salivary pH, and postoperative salivary pH values were always lower than the active range of oral lysozymes in the control group. The salivary pH values of the experimental group were higher than those of the control group from postoperative days 6 to 14 (P < .05). The incidence of oral candidiasis was 13.0% in the control group, which was higher than that in the experimental group (2.0%; P < .05). In addition, advanced age, use of a free flap for the simultaneous repair of intraoral and paraoral defects, and a combination of 2 antibiotic types were risk factors for oral candidiasis.


CONCLUSIONS
Oral candidiasis was common in patients after free flap reconstruction surgery, and the use of 3% sodium bicarbonate saline solution for oral care effectively prevented it.
Chief Nurse, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Yue
Y
Yang
Supervisor Nurse, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
Fang
F
Zhang
Candidate, Resident, Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
Xin
X
Lyu
Associate Professor, Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
Zhimin
Z
Yan
Professor, Department of Oral Medicine, Peking University School and Hospital of Stomatology, Beijing, China.
Hong
H
Hua
Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China. Electronic address: pxpengxin@263.net.
Xin
X
Peng
D000284:Administration, Oral; D002180:Candidiasis, Oral / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D006863:Hydrogen-Ion Concentration; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019647:Oral Surgical Procedures; D011446:Prospective Studies; D012463:Saliva / Q000382:microbiology; D017693:Sodium Bicarbonate / Q000008:administration & dosage*
D017693:Sodium Bicarbonate