Preoperative topical antimicrobial decolonization in head and neck surgery

Area of Science:

• Infectious Disease
• Surgical Oncology
• Clinical Trials

Background:

• Surgical site infections (SSIs) are a significant cause of morbidity and mortality following head and neck surgery.
• Identifying effective strategies to prevent SSIs is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of preoperative topical antimicrobial decolonization in reducing SSIs after head and neck surgery.
• To identify risk factors associated with SSIs in this patient population.

Main Methods:

• Prospective, randomized controlled trial involving 84 patients undergoing head and neck surgery.
• Patients received either topical antimicrobial decolonization (chlorhexidine and mupirocin) plus standard prophylaxis or standard prophylaxis alone.
• Preoperative cultures identified Staphylococcus aureus carriers; SSIs were the primary outcome.

Main Results:

• No statistically significant difference in SSI incidence was observed between the decolonization group (10%) and the control group (24%).
• Higher American Society of Anesthesiologists scores, increased operative blood loss, and operative takeback were associated with higher SSI rates.
• Trends suggested increased SSIs in clean-contaminated cases, and patients with prior radiation or chemotherapy.

Conclusions:

• Preoperative antimicrobial decolonization did not significantly reduce SSIs in head and neck surgery patients.
• The intervention may warrant consideration for high-risk patient groups, pending further evidence.
• This study prospectively identified key risk factors for SSIs in head and neck surgery.