Wound infection in head and neck surgery: prophylaxis, etiology and management

Antibiotic prophylaxis in clean-contaminated major head and neck surgery is mandatory. Many prospective, randomized and double blind studies have established the efficacy of antibiotics against a large spectrum of bacteria. Prophylaxis should be initiated prior to surgery, and prolonged administration of antibiotics beyond the first 24 hours following surgery is unnecessary. The experience of the Eye and Ear Hospital of Pittsburgh is presented along with other studies concerning the effect of different regimens on wound outcome. The pathophysiology, bacteriology, evaluation and treatment of a postoperative infection are discussed, emphasizing the importance of gentle tissue handling and meticulous surgical technique.