Ineffectiveness of closed suction drainage cultures in the prediction of bacteriologic findings in wound infections in patients undergoing contaminated head and neck cancer surgery.

Despite the use of perioperative antibiotics, wound infection remains a major source of morbidity after contaminated head and neck cancer surgery. Accurate preoperative indentification of the patient likely to develop wound infection or prediction of the pathogenic organisms would allow a rational approach to antibiotic prophylaxis or initiation of therapy at the first sign of infection. This prospective study of patients undergoing contaminated head and neck cancer surgery evaluated cultures from hemovac lines in the prediction of the patient at high risk for wound infection and the bacteriologic findings in subsequent wound infections. Cultures were obtained from aspirates of the hemovac lines in 30 patients; 13% (four of 30 patients) developed a wound infection. Aerobic isolates were recovered in 100% (30 of 30 patients). Pathogens were isolated from 75% (three of four) and 73% (19 of 26) of patients with and without infection, respectively. Anaerobic bacteria were recovered in 8% (two of 26) of patients. There was a correlation between hemovac isolates and the patient's subsequent recovery from the wound infection in 50% (two of four) of the infected wounds. Cultures of hemovac lines in patients undergoing contaminated head and neck cancer surgery were not predictive of the high-risk patient or the bacteriologic findings in subsequent wound infections.