Factors affecting wound infection rates in head and neck surgery

PURPOSE: This study was planned with 2 goals in mind: to evaluate the effic acy of prolonged and 1-day antibiotic regimens for prophylaxis and to evalu ate the effect of various factors such as neck dissection, localization and stage of tumor, type of laryngectomy, and history of prior radiotherapy, t racheotomy, and diabetes mellitus on postoperative wound infection rates. METHODS AND MATERIAL: In this study, 408 head and neck procedures (201 clea n and 207 clean-contaminated) performed at our institution were retrospecti vely reviewed. RESULTS: Prolonged and I-day antibiotic regimens for both clean and clean-c ontaminated procedures were similar in efficacy (7% vs 3% for clean procedu res (P = 0.165) and 30% vs 28% for clean-contaminated procedures (P = 0.777 )). The wound infection rate wets higher (13%) after clean radical neck dis sections versus other clean procedures (1%) (P = 0.001). For clean-contamin ated procedures, factors affecting postoperative wound infection rates were performance of bilateral neck dissections (P = 0.014), disease stage (P = 0.002), type of laryngectomy (P = 0.002), and history of prior tracheotomy (P = 0.006).