Surgical site infection in clean-contaminated wounds after multimodal treatment of advanced oral squamous cell carcinoma.
OBJECTIVE
The aim of this study was to assess the incidence rate for surgical site infections (SSI), patient- and therapy-related risk factors in UICC stage III and IV oral squamous cell carcinoma patients treated with preoperative radiochemotherapy, ablative surgery and immediate microvascular free flap reconstruction.


METHODS
This retrospective analysis included 85 patients with oral squamous cell carcinoma treated by neoadjuvant radiochemotherapy, tumor surgery and immediate free flap reconstruction. Patient-, therapy-related factors and blood parameters were collected for this selective cohort.


RESULTS
The incidence for SSI was 44.7% and for transplant loss 14.1%. Minor BMI changes (p = 0.010), diabetes (p = 0.003), edentulous status (p = 0.006) and cessation of alcohol consumption (0.034) showed to be significant patient-related risk factors. No therapy-related factors were found to be significantly influencing the risk for SSI. Neutrophil counts (p = 0.027) and GGT (p = 0.002) were found to be significantly linked to SSI.


CONCLUSIONS
The not so common treatment option for oral squamous cell carcinomas showed no more risk for SSI compared to standard treatment options. Preserving the ability for healthy nutrition has a significant impact on the development of SSI. This applies not only to the presented and particular treatment option.
University Clinic of Cranio, Maxillofacial and Oral Surgery (Head: Prof. E. Nkenke), Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Electronic address: christina.eder-czembirek@meduniwien.ac.at.
Christina
C
Eder-Czembirek
Center of Excellence of Cranio, Maxillofacial and Oral Surgery and Pediatric Dentistry, Sozialmedizinisches Zentrum Ost - Donauspital, Langobardenstraβe 122, 1220 Vienna, Austria.
Cornelia
C
Czembirek
University Clinic of Cranio, Maxillofacial and Oral Surgery (Head: Prof. E. Nkenke), Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Pamela
P
Braun
University Clinic of Cranio, Maxillofacial and Oral Surgery (Head: Prof. E. Nkenke), Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Christos
C
Perisanidis
University Clinic of Cranio, Maxillofacial and Oral Surgery (Head: Prof. E. Nkenke), Medical University Vienna, Vienna General Hospital, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Rudolf
R
Seemann
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery* / Q000628:therapy; D059186:Chemoradiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D058752:Free Tissue Flaps / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology*
Neoadjuvant radiochemotherapy; Oral squamous cell carcinoma; Patient-related risk factors; Surgical site infection; Therapy-related risk factors