a Faculty of Medicine and Defence Health , Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia) , Kuala Lumpur , Malaysia.
b Swansea University School of Medicine , Grove Building, Swansea University , Swansea , Wales , UK.
Expert Rev Anticancer Ther. 2019 Jan;19(1):81-92. doi: 10.1080/14737140.2019.1544497. Epub 2018 Nov 14.
: Surgery in patients with head and neck cancers is frequently complicated by multiple stages of procedure that includes significant surgical removal of all or part of an organ with cancer, tissue reconstruction, and extensive neck dissection. Postoperative wound infections, termed 'surgical site infections' (SSIs) are a significant impediment to head-and-neck cancer surgery and recovery, and need to be addressed. : Approximately 10-45% of patients undergoing head-and-neck cancers surgery develop SSIs. SSIs can lead to delayed wound healing, increased morbidity and mortality as well as costs. Consequently, SSIs need to be avoided where possible, as even the surgery itself impacts on patients' subsequent activities and their quality of life, which is exacerbated by SSIs. Several risk factors for SSIs need to be considered to reduce future rates, and care is also needed in the selection and duration of antibiotic prophylaxis. : Head and neck surgeons should give personalized care especially to patients at high risk of SSIs. Such patients include those who have had chemoradiotherapy and need reconstructive surgery, and patients from lower and middle-income countries and from poorer communities in high income countries, who often have high levels of co-morbidity because of resource constraints.
手术治疗头颈部癌症通常需要经历多个阶段，包括对所有或部分有癌症的器官进行广泛切除、组织重建和颈部广泛解剖。术后伤口感染，即“手术部位感染”（SSI），是头颈部癌症手术和康复的严重障碍，需要加以处理。
约有 10-45%的头颈部癌症手术患者会发生 SSI。SSI 可导致伤口愈合延迟、发病率和死亡率增加以及费用增加。因此，应尽可能避免 SSI，如果发生 SSI，即使是手术本身也会影响患者后续的活动和生活质量，这会因 SSI 而进一步恶化。需要考虑多种 SSI 的风险因素以降低未来的发生率，还需要注意抗生素预防的选择和持续时间。
头颈部外科医生应给予患者个性化的护理，尤其是那些有发生 SSI 高风险的患者。这些患者包括接受过放化疗且需要重建手术的患者，以及来自中低收入国家和高收入国家贫困社区的患者，由于资源限制，他们通常有较高水平的合并症。
