Patterns of practice regarding surgical site infection prevention in head & neck surgery: An international survey.

INTRODUCTION: Head & neck surgery encompasses a variety of surgical approaches for benign and malignant conditions. Due to the complexity in treating patients with head and neck pathology, it is necessary to adhere to basic surgical principles to decrease complications. Among them, surgical site infection can be prevented using a surgery quality protocol including the correct use of antibiotics and optimization of nutritional status. MATERIALS AND METHODS: A survey was sent through the YO-IFOS and SEORL-CCC international mailing list. RESULTS: A total of 435 surgeons completed the survey. Of the respondents, 97.7% confirm that they scrub their hands before surgery, 40.9% respondents recommend nutritional support according to sign and symptoms, 60.9% use of antibiotic prophylaxis in clean surgery and just 9.2% use clindamycin in combination. CONCLUSION: This survey has broadened the scope regarding H&N surgical safety around the globe. Identifying innovative ways in which surgical care may be improved is mandatory.

Patterns of practice regarding surgical site infection prevention in head & neck surgery: An international survey

IntroductionHead & neck surgery encompasses a variety of surgical approaches for benign and malignant conditions. Due to the complexity in treating patients with head and neck pathology, it is necessary to adhere to basic surgical principles to decrease complications. Among them, surgical site infection can be prevented using a surgery quality protocol including the correct use of antibiotics and optimization of nutritional status.Materials and methodsA survey was sent through the YO-IFOS and SEORL-CCC international mailing list.ResultsA total of 435 surgeons completed the survey. Of the respondents, 97.7% confirm that they scrub their hands before surgery, 40.9% respondents recommend nutritional support according to sign and symptoms, 60.9% use of antibiotic prophylaxis in clean surgery and just 9.2% use clindamycin in combination.ConclusionThis survey has broadened the scope regarding H&N surgical safety around the globe. Identifying innovative ways in which surgical care may be improved is mandatory. (AU)

IntroducciónLa cirugía de cabeza y cuello abarca una variedad de técnicas quirúrgicas dirigidas al tratamiento de un grupo de enfermedades benignas y malignas. Debido a la complejidad en el tratamiento de este tipo de pacientes el uso de protocolos quirúrgicos va a permitir disminuir las diversas complicaciones, entre ellas la infección del sitio quirúrgico, que será posible prevenirla mediante la adopción de protocolos de control quirúrgico que incluya, por ejemplo, el uso correcto de antibióticos y la optimización del estado nutricional.Materiales y métodosPara este estudio se envió una encuesta a través de la lista de correo electrónico del grupo internacional YO-IFOS y de la SEORL-CCC.ResultadosUn total de 435 cirujanos completaron la encuesta. El 97,7% de los encuestados confirmó practicar el lavado de manos antes de la cirugía, el 40,9% refirió recomendar el apoyo nutricional en el periodo perioperatorio según los signos y síntomas del paciente, el 60,9% refirió utilizar profilaxis antibiótica en cirugía limpia y solo el 9,2% utilizar clindamicina en combinación.ConclusiónEsta encuesta intenta analizar el alcance de los protocolos de seguridad quirúrgica a nivel mundial, con la intención de identificar formas innovadoras de mejorar los resultados quirúrgicos en cirugía de cabeza y cuello. (AU)

Orbito-Cranial Gunshot Injuries with Retained Sinonasal Bullets.

INTRODUCTION: Gunshot injuries to the sino-orbital region are rare. In South Africa, where gunshot injuries are common, sino-orbital gunshot injuries are encountered. Sino-orbital gunshot injuries are associated with trauma to surrounding facial and intracranial structures. Therefore, the management of these injuries may be complex and often requires an interdisciplinary approach. AIMS: To review the management of orbito-cranial gunshot injuries with retained sinonasal bullets. PATIENTS AND METHODS: Three cases of orbito-cranial gunshot injuries with retained sinonasal bullets were reviewed. Two cases were complicated by cerebrospinal fluid leaks with ensuing meningitis. The retained bullets in all three cases were successfully removed via a transnasal endoscopic approach. CONCLUSION: Sino-orbital gunshot injuries are rare, but may be encountered in areas with high frequencies of gun violence. An associated anterior skull base fracture with CSF rhinorrhoea poses a risk for meningitis and a low threshold for diagnosis and treatment of meningitis should be maintained. Retained bullets in the paranasal sinuses do not pose an immediate risk and may be removed on an elective basis.