Initiatives to reduce postoperative surgical site infections of the head and neck cancer surgery with a special emphasis on developing countries |
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Authors: | Mainul Haque Judy McKimm Brian Godman Muhamad Abu Bakar Massimo Sartelli |
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Affiliation: | 1. Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia;2. Swansea University School of Medicine, Grove Building, Swansea University, Swansea, Wales, UK;3. Strathclyde Institute of Pharmacy and Biomedical Sciences, Strathclyde University, Glasgow, United Kingdom;4. Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden;5. Department of Public Health Pharmacy and Management, School of Pharmacy, Sasako Makgatho Health Sciences University, Garankuwa, South Africa;6. Department of Surgery, Macerata Hospital, Via Santa Lucia 2, 62100 Macerata, Italy |
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Abstract: | Introduction: 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. Areas covered: 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. Expert commentary: 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. |
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Keywords: | Healthcare postoperative surgical site infections head neck cancer surgery |
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