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Purpose <p>SSI (surgical site infection) is one of the most frequent postoperative complications of&#xa0;oral cancer&#xa0;surgery, which causes detrimental effect in overall management and outcome.</p> <p>To study the risk factors for SSI in head and neck cancer patients which were treated with curative intent and implement its finding in suggesting intervention. It also evaluated the efficacy of preoperative oral swab culture-based antibiotic prophylaxis.</p> Method <p>A study was done on 424 patients of oral cancer at BALCO Medical Centre, Raipur—from July 2019 to June 2020. It was done in two phase. Patients were subjected to prophylactic antimicrobial agents based on the institutional antibiotic policy in preintervention phase. SSI and various risk factors were recorded.</p> <p>Based on the results of first phase, intervention was planned. In intervention phase, preoperative oral swabs were collected for average 80.85% cases along with frequent mouth wash with Chlorhexidine. In 54% cases, there was predominant growth of Pseudomonas aeruginosa. P. aeruginosa is resistant to Cefuroxime and Metronidazole. Hence, surgical prophylaxis was changed to Cefoperazone sulbactam in these cases.</p> <p>SSI rate in preintervention phase were compared with post-intervention phase.</p> Result <p>We found that the preoperative culture-based antibiotic caused drastic reduction in SSI rate from average 27% in preintervention period to 4% in post-intervention period.</p> Conclusion <p>We propose guided surgical prophylaxis for head and neck surgeries along with risk assessment to reduce risk of SSI in immediate postoperative period.</p>

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Risk Stratification of Surgical Site Infection in Head and Neck Surgery and Preoperative Oral Swab Culture-Based Antibiotic Prophylaxis: Our Institutional Experience

  • 期刊论文

  • 发表日期：

    2025年10月12日

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  • Rashmi S. Rai,
  • Shreshtha Tiwari,
  • Sandeep Ojha,
  • Dipmalya Chatterjee

摘要

Purpose

SSI (surgical site infection) is one of the most frequent postoperative complications of oral cancer surgery, which causes detrimental effect in overall management and outcome.

To study the risk factors for SSI in head and neck cancer patients which were treated with curative intent and implement its finding in suggesting intervention. It also evaluated the efficacy of preoperative oral swab culture-based antibiotic prophylaxis.

Method

A study was done on 424 patients of oral cancer at BALCO Medical Centre, Raipur—from July 2019 to June 2020. It was done in two phase. Patients were subjected to prophylactic antimicrobial agents based on the institutional antibiotic policy in preintervention phase. SSI and various risk factors were recorded.

Based on the results of first phase, intervention was planned. In intervention phase, preoperative oral swabs were collected for average 80.85% cases along with frequent mouth wash with Chlorhexidine. In 54% cases, there was predominant growth of Pseudomonas aeruginosa. P. aeruginosa is resistant to Cefuroxime and Metronidazole. Hence, surgical prophylaxis was changed to Cefoperazone sulbactam in these cases.

SSI rate in preintervention phase were compared with post-intervention phase.

Result

We found that the preoperative culture-based antibiotic caused drastic reduction in SSI rate from average 27% in preintervention period to 4% in post-intervention period.

Conclusion

We propose guided surgical prophylaxis for head and neck surgeries along with risk assessment to reduce risk of SSI in immediate postoperative period.