Related Experiment Videos
Extended Antibiotic Prophylaxis Is Not Associated with Improved Outcomes after Traumatic Neck Aerodigestive Repair
Tyler L Holliday1, Christian D Cain1,2, Logan N Gonsalves3
1Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Background:
Extended post antibiotics do not reduce infectious complications after traumatic facial injuries or elective clean-contaminated head and neck operation. However, the optimal duration of antibiotic prophylaxis following operative repair of traumatic neck aerodigestive injuries remains uncertain. This study compared outcomes between perioperative (≤24 hours) and extended (>24 hours) antibiotic prophylaxis and hypothesized that extended prophylaxis would not reduce local infectious complications.
Methods:
Using a Level I and II university-based trauma system registry, patients undergoing operative repair of traumatic neck aerodigestive injuries (oropharynx, hypopharynx, larynx, esophagus, and trachea) were identified over an 8-year period (2017-2024). Demographics, injury characteristics, management strategies, and antibiotic use were collected. Patients were stratified by antibiotic prophylaxis duration (perioperative vs. extended). The primary outcome was local infectious complications. Secondary outcomes included leak, stenosis, reintervention, length of stay, and mortality.
Results:
Sixty-five patients with operative penetrating or blunt neck aerodigestive injuries were identified: 35 received perioperative antibiotics and 30 received an extended course. Most injuries were penetrating (93.8%). Extended antibiotics were prescribed more frequently in older patients (40.5 vs. 29 years, p < 0.01), while injury characteristics and adjunctive management strategies were otherwise similar. Local infectious complication rates did not differ significantly between the perioperative and extended antibiotic groups (5.7% vs. 20%, p = 0.13). Rates of leak, stenosis, reintervention, length of stay, and mortality were also similar. No patient, injury, or management factor was associated with local infectious complications.
Conclusions:
Extended post antibiotic prophylaxis was not associated with lower infection rates or improved clinical outcomes following operative repair of traumatic neck aerodigestive injuries. Prospective multicenter studies are needed to validate these findings and refine antibiotic protocols for these injuries.
Related Concept Videos
01:26Tonsillitis II: Management
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:22Aneurysm IV: Nursing Management
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...