Infective complications after free flaps reconstruction in patients affected by head and neck cancer

Abstract

AIM: The success rates of free flaps in patients undergoing head and neck cancer (HNC) surgery are very high (95%- 97%) but the development of a surgical site infection (SSI) can put flap viability at risk. The aim of our study is to identify the risk factors for SSI in patients undergo free flaps reconstruction after head and neck cancer removal.

MATERIAL OF STUDY: Seventyseven patients (44 male and 33 female) from April 2006 to April 2015 admitted at the Department of Maxillofacial Surgery of the University of Naples “Federico II” were included in this study. All the patients underwent free flap reconstruction for HNC.

RESULTS: A microbiological analysis in 32 patients with signs of SSIs was performed, and 27 (35%) patients showed positive culture results, 5 patients were false positives.

DISCUSSION: SSIs are one of the most common nosocomial infections that increase medical costs. HNC surgery frequently requires opening of the mouth floor, oropharynx, nasopharynx, or proximal esophagus, and these areas are likely to be contaminated by local microbiotics. Positive significant correlation between long operation timing and SSIs.

CONCLUSION: Was observed the factors contributing to postoperative infections for patients affected by head and neck tumor. 35% of our study population developed an SSI (27/77). The most commonly discovered pathogen was MRSA (Methicillin-resistant Staphylococcus aureus). Were examinated sex, cardiovascular disease, blood loss more than 560 mL, and a long operation time ≥ 6 hours were significant risk factors for SSI.