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Contamination of the surgical field in head and neck oncologic surgery

Maciej J Mazurek1, Maciej Rysz, Janusz Jaworowski

  • 1Student Research Group, Head and Neck Cancer Department, Maria Sklodowska-Curie Cancer Center, Warsaw, Poland.

Head & Neck
|September 17, 2013
PubMed
Abstract

Insights

Surgical field contamination is common during head and neck cancer surgery, even with aseptic techniques. However, this bacterial contamination rarely leads to surgical site infections.

Area of Science:

  • Oncology
  • Microbiology
  • Surgical Sciences

Background:

  • Advanced head and neck cancer resections often involve complex procedures.
  • Simultaneous tissue reconstruction is frequently performed.
  • Surgical site infections (SSIs) are a potential complication.

Purpose of the Study:

  • To investigate the timing and types of surgical field contamination.
  • To assess contamination during head and neck cancer resections with reconstruction.
  • To analyze the link between contamination and SSIs.

Main Methods:

  • 50 consecutive advanced head and neck cancer resections with reconstruction were studied.
  • Surgical field and drape swabs were collected at 0, 2, 4, and 6 hours.
  • Microbiological analysis was performed on all collected samples.

Main Results:

  • 71% of 336 collected swabs showed contamination.
  • Polymicrobial contamination occurred in 45% of samples.
  • Streptococcus species were the most frequent pathogen; 3 patients developed SSIs.

Conclusions:

  • Standard aseptic procedures do not eliminate surgical field contamination in these procedures.
  • Physiological bacterial flora from skin and oral cavity commonly contaminate the surgical field.
  • Despite frequent contamination, surgical site infections remain rare.
Keywords:
free flapshead and neck cancersurgical field contaminationsurgical site infectionswabs

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