Factors affecting wound complications in head and neck surgery: A prospective study
- PMID: 24604952
- PMCID: PMC3932590
- DOI: 10.4103/0971-5851.125236
Factors affecting wound complications in head and neck surgery: A prospective study
Abstract
Context: Head and neck surgeries are complex. Wound complications are associated with considerable morbidity and can result in delay in the adjuvant treatment. Identification of factors will help in formulating preventive guidelines.
Aims: The aim of this study is to identify perioperative factors responsible for wound complications.
Settings and design: Prospective study of 186 head and neck patients.
Subjects and methods: Pre-operative, intraoperative and post-operative factors were recorded. Each patient was evaluated for minor and major wound complications twice daily during the hospital stay.
Statistical analysis: Chi-square test was used for univariate and log regression test was used for multivariate analysis.
Results: The overall wound complication rate was 29% with 7% major and 22% minor complications. On univariate analysis, laryngeal and hypopharyngeal location, advanced T stage, poor oral hygiene, clean-contaminated surgery, low Karnofsky performance status (KPS), flap reconstruction, blood loss more than 1000 ml, perioperative blood transfusion, duration of surgery greater than 4.3 h and post-operative hemoglobin lesser than 11 g%, post-operative tracheostomy and resection of mandible were statistical significant factors. On multivariate analysis, post-operative tracheostomy, low KPS, post-operative serum albumin less than 3.7 g/dl and duration of surgery greater than 4.3 h were significant factors.
Conclusion: Apart from unavoidable factors, it is essential to take care of certain factors viz nutrition, haemoglobin, oral hygiene, asepsis and repeating antibiotics in prolonged surgery.
Keywords: Head and neck cancers; risk factors; wound complications; wound infection.
Conflict of interest statement
References
-
- Parsons JT, Mendenhall WM, Stringer SP, Cassisi NJ, Million RR. An analysis of factors influencing the outcome of postoperative irradiation for squamous cell carcinoma of the oral cavity. Int J Radiat Oncol Biol Phys. 1997;39:137–48. - PubMed
-
- Penel N, Lefebvre D, Fournier C, Sarini J, Kara A, Lefebvre JL. Risk factors for wound infection in head and neck cancer surgery: A prospective study. Head Neck. 2001;23:447–55. - PubMed
-
- Penel N, Fournier C, Lefebvre D, Lefebvre JL. Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures. Oral Oncol. 2005;41:294–303. - PubMed
-
- Penel N, Fournier C, Roussel-Delvallez M, Lefebvre D, Kara A, Mallet Y, et al. Prognostic significance of wound infections following major head and neck cancer surgery: An open non-comparative prospective study. Support Care Cancer. 2004;12:634–9. - PubMed
-
- Belusic-Gobic M, Car M, Juretic M, Cerovic R, Gobic D, Golubovic V. Risk factors for wound infection after oral cancer surgery. Oral Oncol. 2007;43:77–81. - PubMed
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