Department of Oral Pathobiological Science, Hokkaido University, Graduate School of Dental Medicine, Kita-ku, Sapporo, Japan.
Support Care Cancer. 2011 Mar;19(3):409-16. doi: 10.1007/s00520-010-0853-6. Epub 2010 Mar 16.
Postoperative wound infection (WI) is a main complication after head and neck surgery. Poor oral health may be a risk factor for WI. We therefore assessed the contribution of oral health care in preventing postoperative WI in patients with oral squamous cell carcinoma (OSCC).
A total of 66 consecutive inpatients with OSCC (mean age, 68 years) was divided into two groups that did or did not receive oral health care. There were no significant between group differences in gender, age, or T-, N-, or clinical stage. Patients in the care group were given oral health care plans by doctors of oral medicine, whereas patients in the control group were not. Twenty-three variables were recorded for each patient.
WI was observed in 14/66 patients (21%), three (3/33 = 9%) in the care group and 11 (11/33 = 33%) in the control group (p < 0.025). Univariate statistical analysis showed that 11 factors correlated with WI significantly: T-stage, clinical stage, wearing of dentures, tracheostomy, neck dissection, tissue transplantation, oral health care, preoperative radiation, blood transfusion, operation time, and blood loss. In multiple logistic regression analysis, only two factors were significant independent risk factors for WI: tissue transplantation (p = 0.01; odds ratio, 24.5) and lack of oral health care (p = 0.04; odds ratio, 6.0).
Oral health care may reduce the risk of postoperative WI in patients with OSCC.
术后伤口感染(WI)是头颈部手术后的主要并发症。口腔健康状况不佳可能是 WI 的一个危险因素。因此,我们评估了口腔保健在预防口腔鳞状细胞癌(OSCC)患者术后 WI 中的作用。
将 66 例连续住院的 OSCC 患者(平均年龄 68 岁)分为接受口腔保健组和未接受口腔保健组。两组在性别、年龄、T、N 或临床分期方面无显著差异。口腔医学医生为保健组患者制定口腔保健计划,而对照组患者则未接受。记录每位患者的 23 个变量。
66 例患者中有 14 例(21%)发生 WI,保健组 3 例(3/33=9%),对照组 11 例(11/33=33%)(p<0.025)。单因素统计分析显示,有 11 个因素与 WI 显著相关:T 分期、临床分期、戴假牙、气管切开术、颈部清扫术、组织移植、口腔保健、术前放疗、输血、手术时间和出血量。多因素逻辑回归分析显示,仅有两个因素是 WI 的独立显著危险因素:组织移植(p=0.01;优势比,24.5)和缺乏口腔保健(p=0.04;优势比,6.0)。
口腔保健可能降低 OSCC 患者术后 WI 的风险。