当前位置： SCI文献检索 > AMERICAN JOURNAL OF OTOLARYNGOLOGY期刊下所有文献 > Extended use of perioperative antibiotics in head and neck microvascular reconstruction.

Extended use of perioperative antibiotics in head and neck microvascular reconstruction.

Abstract：

PURPOSE:Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant - especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24hour post-operatively. Currently, there is no consensus on appropriate antibiotic regimen or duration at this time. This study investigates the outcomes of a 7-day perioperative antibiotic regimen after microvascular reconstruction of the head and neck at our institution. MATERIALS AND METHODS:A retrospective review was performed of 72 patients undergoing microvascular free tissue at our institution between 09/2011 and 03/2014. The antibiotic regimen, post-operative surgical (including surgical site infections) and medical complications were noted. Our rates of complications and adverse events were compared to all surgical patients, as well as all inpatients hospital-wide with use of the University Health System Consortium database. RESULTS:Seventy-two subjects met inclusion criteria for this study. The majority of subjects received cefazolin/metronidazole (69.4%). Subjects with beta-lactam allergy received clindamycin (12.5%). The remainder received an alternative regimen (18.1%). All received at least 7days of antibiotics. The rate of hospital acquired C. difficile diarrhea was 0.57% hospital-wide, 1.13% in Otolaryngology patients, and 1.4% in this study. There were no instances of a multi-drug resistant infection or any adverse reactions to the administration of antibiotics. When compared with other antibiotic regimens, clindamycin was associated with a significantly increased rate of either medical or surgical infections (OR 14.38, p=0.02) and longer hospital stay (average=18days, p<0.05). CONCLUSION:The use of a 7-day prophylactic antibiotic regimen is not associated with an increased risk of antibiotic-associated infections, multi-drug resistant infections, or antibiotic-associated complications. The use of clindamycin is associated with increased risk of medical and surgical infections post-operatively and should be avoided in the prophylactic perioperative phase after free tissue transfer of the head and neck.

journal_name

Am J Otolaryngol

journal_title

American journal of otolaryngology

authors

Saunders S,Reese S,Lam J,Wulu J,Jalisi S,Ezzat W

doi

10.1016/j.amjoto.2017.01.009

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

204-207

issue

eissn

0196-0709

issn

1532-818X

pii

S0196-0709(16)30468-9

journal_volume

pub_type

杂志文章

在线工具

Extended use of perioperative antibiotics in head and neck microvascular reconstruction.