Infection following uncontaminated head and neck surgery

The efficacy of perioperative antibiotic administration during major head and neck surgery in which the wound is contaminated by saliva has been clearly established. This study was undertaken to ascertain the incidence of postoperative wound infection encountered in patients undergoing major head and neck surgery in which no contamination occurred. The records of 438 patients who had undergone parotidectomy, thyroidectomy, or submandibular gland excision were reviewed retrospectively. Eighty percent of the patients had received no perioperative antibiotic therapy. Infections developed in three (0.7%) patients during one month following surgery. One of these patients had received perioperative antibiotic prophylaxis. These data clearly demonstrate the non-efficacy of antibiotics administered in patients undergoing parotidectomy, thyroidectomy, or submandibular gland excision when no infection exists prior to surgery.