Acinetobacter: An Enemy after Head and Neck Cancer Operations with Microvascular Free Flap Reconstruction?
Surg Infect (Larchmt)
; 22(4): 442-446, 2021 May.
Article
em En
| MEDLINE
| ID: mdl-32915713
ABSTRACT
Background:
Patients after head and neck cancer reconstructive surgical procedures are predisposed to have post-operative surgical site infections (SSI) develop. They are very often caused by multi-drug resistant strains, including Acinetobacter baumannii as the most common one.Methods:
The aim of the study was to determine important risk factors contributing to SSI of A. baumannii origin. The analysis included 134 head and neck cancer patients after salvage operations with microvascular free flap reconstruction. The A. baumannii was cultured in 27 of all 48 infected patients.Results:
The following risk factors were significantly associated with A. baumannii infection re-hospitalization before reconstructive operation (p = 0.00011), massive blood loss (p = 0.00277), and need of revision surgical procedure (p = 0.00419). Of patients with A. baumannii infection, 48% were hospitalized in a general intensive care unit (ICU) after operation that, together with prolonged intubation, constituted a strong risk factor of that infection (p = 0.01077). Mean time of hospital stay was significantly longer in the A. baumannii group (58 days vs. 35 days; p = 0.02697).Conclusions:
Our analysis identified a subset of head and neck cancer patients after salvage operation with microvascular free flap reconstruction who are at high risk of A. baumannii infection developing. Previously hospitalized patients with extensive blood loss and need of surgical revision necessitate increased monitoring for the development of this complication. Mechanical ventilation and hospital stay in an ICU should be shortened maximally or avoided in that challenging group of patients. Early recognition of patients at high risk remains a key point to prevent or limit the spread of A. baumannii infections.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Procedimentos de Cirurgia Plástica
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Acinetobacter baumannii
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Retalhos de Tecido Biológico
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Neoplasias de Cabeça e Pescoço
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Surg Infect (Larchmt)
Assunto da revista:
BACTERIOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Polônia