Goyal Neerav, Emerick Kevin S, Deschler Daniel G, Lin Derrick T, Yarlagadda Bharat B, Rich Debbie L, Durand Marlene L
Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Penn State Milton S. Hershey Medical Center, Division of Otolaryngology Head and Neck Surgery, Hershey, Pennsylvania.
Head Neck. 2016 Nov;38(11):1615-1620. doi: 10.1002/hed.24480. Epub 2016 Apr 21.
Surgical site infections can adversely affect flaps in head and neck reconstruction. The purpose of this study was to evaluate the risk factors of surgical site infections in supraclavicular artery island flap reconstructions.
Records of patients undergoing head and neck surgery from 2011 to 2014 with supraclavicular artery island flap reconstruction at a single specialty hospital were reviewed; surgical site infections ≤30 days postoperatively were noted.
Of 64 patients, 86% underwent resection for malignancy, 55% previously received radiation. Sixty-three percent of surgeries were clean-contaminated. Seven patients (11%) developed recipient site surgical site infections, all in patients who underwent clean-contaminated surgery for malignancy. There was no complete flap loss. No significant differences in demographics or perioperative factors were noted. Oral cavity and laryngeal reconstructions (p = .014) and clean-contaminated surgery (p = .04) were factors associated with increased surgical site infection risk on univariate but not multivariate analysis. Patients with surgical site infections had longer hospitalizations (p = .003).
The supraclavicular artery island flap can be used for head and neck reconstruction with a low rate of surgical site infection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.
手术部位感染会对头颈重建中的皮瓣产生不利影响。本研究的目的是评估锁骨上动脉岛状皮瓣重建手术部位感染的危险因素。
回顾了2011年至2014年在一家专科医院接受头颈手术并进行锁骨上动脉岛状皮瓣重建的患者记录；记录术后≤30天发生的手术部位感染情况。
64例患者中，86%因恶性肿瘤接受切除术，55%之前接受过放疗。63%的手术为清洁-污染手术。7例患者（11%）发生了受区手术部位感染，均为因恶性肿瘤接受清洁-污染手术的患者。没有皮瓣完全坏死的情况。在人口统计学或围手术期因素方面未发现显著差异。在单因素分析中，口腔和喉重建（p = 0.014）以及清洁-污染手术（p = 0.04）是与手术部位感染风险增加相关的因素，但在多因素分析中并非如此。发生手术部位感染的患者住院时间更长（p = 0.003）。
锁骨上动脉岛状皮瓣可用于头颈重建，手术部位感染率较低。©2016威利期刊公司。《头颈》2016年第38卷：1708 - 1716页。
