[Risk factors for surgical wound infection development in head and neck cancer surgery]

Over a period of 24 months, patients undergoing surgical procedures for head and neck cancer at the Cancer Hospital in Rio de Janeiro, Brazil were followed-up prospectively for identification of surgical wound risk factors. A total of 273 patients fulfilling the National Nosocomial Infection Surveillance (NNIS) surgical criteria completed the analysis. The overall wound infection rate was 25.3%. Of the 11 potential risk factors for postoperative wound infections analysed by stepwise multiple logistic regression, the five variables that were independent of each other and highly predictive were patient undergoing an operation classified as either contaminated or infected, a surgery lasting longer than 5 hours, an American Society of Anesthesiologist (ASA) preoperative assessment score of 4 and 5, age over 50 years and prior radiotherapy. The preoperative stay, antibiotic prophylaxis, surgical drains, preoperative nutritional status, sex and the presence of prior infection did not have an independent significant contribution to the risk of infection. This study reports specific risk factors for head and neck cancer surgeries and contributes substantially to the effectiveness of infection control strategies to prevent their occurrence in this high-risk group of patients.