Friedman M, Venkatesan T K, Yakovlev A, Lim J W, Tanyeri H M, Caldarelli D D
State University of New York, Syracuse, New York, USA.
Otolaryngol Head Neck Surg. 1999 Oct;121(4):378-80. doi: 10.1016/S0194-5998(99)70224-X.
Fever during the early postoperative period traditionally has not been considered an indication of a postoperative wound infection or breakdown. Atelectasis is considered the most likely source for these early fevers. We studied 200 consecutive patients who underwent major head and neck surgery that involved reconstruction with a pharyngeal suture line. Patients were divided into 2 groups: those who had preoperative irradiation and those who did not. All patients had prophylactic antibiotic coverage, and all patients had identical suture material for closure. We showed a high correlation between fever (>101.5 degrees F) that developed in the first 48 hours and eventual fistula formation and wound infection. We also studied length of hospitalization and number of days until decannulation and resumption of oral feedings. Our data indicate that in those patients in whom fistulas developed, early detection led to earlier healing and rehabilitation.
术后早期发热传统上并不被视为术后伤口感染或破裂的指征。肺不张被认为是这些早期发热最可能的原因。我们研究了200例接受涉及咽缝合线重建的大型头颈手术的连续患者。患者被分为两组：接受术前放疗的患者和未接受术前放疗的患者。所有患者均接受预防性抗生素覆盖，且所有患者用于缝合的材料相同。我们发现术后48小时内出现的发热（>101.5华氏度）与最终的瘘管形成和伤口感染之间存在高度相关性。我们还研究了住院时间以及直至拔管和恢复经口进食的天数。我们的数据表明，在那些发生瘘管的患者中，早期检测可导致更早的愈合和康复。
