Role of prophylactic antibiotics in uncontaminated neck dissections

The use of perioperative prophylactic antibiotics in uncontaminated head and neck surgery remains controversial. We performed a retrospective analysis of 192 patients undergoing uncontaminated neck dissections from 1976 to 1989. Wound infection developed in 10% (10/99) of patients who did not receive antibiotics, while only three (3.3%) of 93 patients who received antibiotics developed infections. This difference was not statistically significant. We correlated the use of flaps, length of surgery, prior radiation treatment, and postoperative complications with rate of wound infection. The difference was not statistically significant for any of these variables. Our beta error was, however, greater than 0.2. Our data do not demonstrate efficacy of prophylactic antibiotics in uncontaminated neck dissections with statistical significance; however, a trend exists suggesting its possible value.