Are More Medically Complex Patients Who Undergo Complex Septorhinoplasty at an Increased Risk for Surgical Site...

Area of Science:

• Otolaryngology
• Plastic Surgery
• Infectious Disease

Background:

• Prophylactic antibiotics are commonly used in septorhinoplasty but their necessity in complex cases is debated.
• Complex septorhinoplasty includes cases with grafts, revisions, extended duration, or high American Society of Anesthesiologists (ASA) scores (≥3).

Purpose of the Study:

• To investigate the association between increased anesthetic complexity, indicated by ASA score, and the risk of surgical site infection (SSI) after complex septorhinoplasty.

Main Methods:

• A retrospective cohort study was conducted on 182 patients undergoing complex septorhinoplasty between 2005 and 2022.
• Patients were categorized by ASA score (≤2 vs. 3), with ASA 3 as the independent variable.
• Surgical site infection (SSI) was the primary outcome, defined by cellulitis, purulence, or fistula requiring antibiotics.

Main Results:

• 101 patients (55%) had an ASA score of 3. Age, male sex, and diabetes were associated with higher ASA scores.
• A total of 6 SSIs (3.3%) occurred, with only 2 in the ASA 3 group (1%).
• An ASA score of 3 was not significantly associated with an increased risk of SSI (P=.27).

Conclusions:

• An ASA score of 3 does not correlate with a higher risk of postoperative infection in complex septorhinoplasty.
• Routine prophylactic postoperative antibiotics may not be warranted for patients undergoing complex septorhinoplasty.