A survey of current wound irrigation practice in head and neck tumour surgery

To determine the frequency of use of irrigation amongst head and neck surgeons in the U.K. and Ireland, the range of fluids in use; to identify differences in practice in benign and malignant surgery, and ascertain common theories about irrigation, wound infection and tumour recurrence.

A postal survey of 695 members of the B.A.O.L. Head and Neck Surgeons (348/695 returned). Eight questions with tick box replies and space for free text. Members were asked about their practice of wound irrigation and opinions on its effect(s). Of 348 returned questionnaires 301 were used, 47 discarded as members had retired.

203 of 301 carried out head and neck tumour surgery (67.44%). 67.98% routinely perform wound irrigation. A variety of fluids are used, the most common being sterile water, then saline (table II). Reducing wound infection and tumour recurrence were reasons for irrigating by 47.1%, reducing infection alone, 15.22%, and reducing tumour recurrence alone, 31.16%. 59.42% believe that irrigation prevents wound seeding by benign tumour cells, 70.29% by malignant cells. Irrigation was performed by 70% of surgeons who did more than 5 head and neck tumour procedures per year and by 56% of surgeons who did less than five.

There is little evidence for the putative effects of wound irrigation as noted from literature. Most studies have been performed on animals. There is a need for further research into wound irrigation, types of fluid used and its effects on head and neck cancer patients.