Surgical site infection in clean-contaminated wounds after multimodal treatment of advanced oral squamous cell carcinoma

J Craniomaxillofac Surg. 2016 Dec;44(12):1957-1962. doi: 10.1016/j.jcms.2016.09.013. Epub 2016 Sep 29.

Abstract

Objectives: The aim of this study was to assess the incidence rate for surgical site infections (SSI), patient- and therapy-related risk factors in UICC stage III and IV oral squamous cell carcinoma patients treated with preoperative radiochemotherapy, ablative surgery and immediate microvascular free flap reconstruction.

Material and methods: This retrospective analysis included 85 patients with oral squamous cell carcinoma treated by neoadjuvant radiochemotherapy, tumor surgery and immediate free flap reconstruction. Patient-, therapy-related factors and blood parameters were collected for this selective cohort.

Results: The incidence for SSI was 44.7% and for transplant loss 14.1%. Minor BMI changes (p = 0.010), diabetes (p = 0.003), edentulous status (p = 0.006) and cessation of alcohol consumption (0.034) showed to be significant patient-related risk factors. No therapy-related factors were found to be significantly influencing the risk for SSI. Neutrophil counts (p = 0.027) and GGT (p = 0.002) were found to be significantly linked to SSI.

Conclusion: The not so common treatment option for oral squamous cell carcinomas showed no more risk for SSI compared to standard treatment options. Preserving the ability for healthy nutrition has a significant impact on the development of SSI. This applies not only to the presented and particular treatment option.

Keywords: Neoadjuvant radiochemotherapy; Oral squamous cell carcinoma; Patient-related risk factors; Surgical site infection; Therapy-related risk factors.

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / surgery*
  • Carcinoma, Squamous Cell / therapy
  • Chemoradiotherapy, Adjuvant / adverse effects
  • Chemoradiotherapy, Adjuvant / methods
  • Combined Modality Therapy / adverse effects
  • Female
  • Free Tissue Flaps / adverse effects
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Mouth Neoplasms / surgery*
  • Mouth Neoplasms / therapy
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Surgical Wound Infection / etiology*