Risk factors of postoperative infection in patients with oral and maxillofacial malignant tumor / 中国感染与化疗杂志

ABSTRACT

Objective To analyze the factors associated with postoperative surgical site infection(SSI)in patients with oral and maxillofacial malignancy. Methods A retrospective study was performed on 240 patients after surgical treatment of oral and maxillofacial malignancies. The incidence of postoperative SSI was calculated in terms of the location of tumor. Preoperative serum albumin level, preoperative periodontal calculus, surgical approach, intraoperative antibiotic use, intraoperative blood loss, length of surgery, duration of indwelling catheter, length of hospital stay, postoperative drainage tubes, and length of ICU stay were considered as potential risk factors for SSI in patients with oral and maxillofacial malignancy. These factors were compared between the patients with SSI and those without SSI by univariate analysis. The significant factors identified by univariate analysis(P<0.05)were included in multivariate logistic regression analysis to identify the independent risk factors. Results The highest incidence of SSI was found in patients with tongue cancer, followed by patients with carcinoma of buccal mucosa, carcinoma of lip, and carcinoma of gingiva. No infection was found in the patients with carcinoma of palate(P<0.05). Univariate analysis identifid that preoperative serum albumin level ≤ 35 g/L, preoperative periodontal calculus level 3, surgical approach III(extended resection + cervical lymph node dissection + flap repair), intraoperative use of antibiotics, duration ofindwelling catheter ≤ 24 h, length of hospital stay>18 days, postoperative drainage tube were significant factors of SSI(P<0.05). There were no statistically significant differences between the non-infected group and the infected group in intraoperative blood loss, duration of surgery and ICU stay(P>0.05). Multivariate logistic regression analysis found that preoperative periodontal calculus level 3(OR=7.149, P=0.014), preoperative serum albumin level ≤ 35 g/L(OR = 0.059, P=0.034), surgical approach III(OR=4.135, P=0.024), hospital stay>18 days(OR=24.845, P=0.009)were the independent risk factors for postoperative SSI in patients with oral and maxillofacial malignancy. Conclusions Preoperative periodontal calculus level 3, preoperative serum albumin level ≤ 35 g/L, surgical approach III, and hospital stay>18 days are independent risk factors for SSI in patients with oral and maxillofacial malignancy. Such SSI is relatively more prevalent in patients with tongue cancer. Corresponding measures should be taken for prevention of postoperative SSI in such patients.