scholarly journals Unplanned Hospital Readmission and Visit to the Emergency Room in the First Thirty Days after Head and Neck Surgery: A Prospective, Single-center Study

2021 ◽  
Author(s):  
Carlos Miguel Chiesa-Estomba ◽  
Jon Alexander Sistiaga-Suárez ◽  
José Ángel González-García ◽  
Ekhiñe Larruscain Sarasola ◽  
Ariadna Valldeperes Vilanova ◽  
...  
Keyword(s):  
Emergency Room ◽  
Head And Neck ◽  
Outpatient Clinic ◽  
Hospital Readmission ◽  
Readmission Rate ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Major Surgery ◽  
Wound Complications ◽  
Surgery Group

Abstract Introduction Head and neck surgery remains a complex field; the patients can suffer important functional or life-threating complications after treatment that need unplanned readmissions, increasing the cost related to the treatment. Objective To evaluate the incidence risk factors and causes associated with 30-day unplanned hospital readmission and visit to the emergency room (ER) after surgery for head and neck cancer. Methods Prospective, longitudinal, nonrandomized study. Results A total of 834 patients were included, 726 in the major surgery group and 108 in the minor surgery group. The 30-day readmission rate for all causes was of 7,9% for the patients treated by a major surgery and of 0% for the patients treated in the outpatient clinic for minor procedures, to a total readmission rate of 6,8%. The rate of visit to the emergency room for all causes in the first 30 days was of 14% for the patients treated by a major surgery and of 2,7% for the patients treated in the outpatient clinic. Conclusion Major surgery, the American Society of Anesthesiologists (ASA) status and type of wound are conditions related to unplanned readmission or visit to the ER in the first 30 day after discharge. The most commonly associated causes are infections or wound complications. An evidence-based risk stratification of the patients can be important to improve decision-making and resource utilization. An educational strategy can provide possible ways to improve the rate of readmission and reduce the amount of money expended by healthcare systems.

Topical antiseptic mouthwash in oncological surgery of the oral cavity and oropharynx

1994 ◽  
Vol 108 (11) ◽  
pp. 973-979 ◽  
Author(s):  
Miriam I. Redleaf ◽  
Carol A. Bauer
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Oral Presentation ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Wound Complications ◽  
University Of Iowa ◽  
Wound Breakdown ◽  
Oral Preparation ◽  
Operative Wound

AbstractA multivariant analysis of the value of the use of a pre-operative topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in 106 consecutive patients undergoing head and neck surgery involving the oral cavity or oropharynx was carried out at the University of Iowa, Department of Otolaryngology-Head and Neck Surgery. An oral presentation employing povidone–iodine solution was used for 43 patients. The remaining 63 patients studied received no oral presentation. Unfavourable wound outcome was not associated with age, sex, presence and condition of teeth, or serious pre-existing medical illnesses. A significant correlation was found between post-operative wound breakdown and type of closure, stage of disease, and previous operation or radiotherapy. The use of an oral preparation correlated significantly with favourable wound outcome independent of all other variables (p<0.01).Our data support the use of a topical antiseptic mouthwash to reduce the incidence of post-operative wound complications in surgery of the oral cavity and oropharynx.

Surgical Site Infection in Head and Neck Surgery: A National Perspective

2019 ◽  
Vol 161 (1) ◽  
pp. 52-62 ◽  
Author(s):  
Zaid Al-Qurayshi ◽  
Jarrett Walsh ◽  
Scott Owen ◽  
Emad Kandil
Keyword(s):  
Surgical Site Infection ◽  
Health System ◽  
Head And Neck ◽  
Mortality Risk ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Major Surgery ◽  
Site Infection ◽  
Linear Regression Models ◽  
Cross Sectional

Objectives To examine trend, prevalence, and outcomes of surgical site infection (SSI) in head and neck surgery. Study Design Retrospective cross-sectional analysis. Setting The Nationwide Readmissions Database (2010-2014), which represents 56.6% of all US hospitalization. Subjects Adult patients (≥18 years) who underwent head and neck surgery. Patients with SSI were compared with controls. Methods Analysis included chi-square test and multivariate logistic and linear regression models. Results A total of 427 cases and 116,921 controls were identified. SSI prevalence among patients who underwent head and neck surgery was 0.37%, of which 41.0% was reported within the initial admission while the remaining 59.0% was reported on readmission within 30 days of first surgery. SSI was associated with a higher mortality risk (odds ratio, 3.95; 95% CI, 1.25-12.50; P = .019). Multivariate analysis demonstrated that a higher risk of SSI was associated with major surgery of the ear, nose and paranasal sinuses, mouth and tonsil, salivary glands and ducts, maxillofacial bones and mandible, and pharynx and larynx ( P < .05 each). However, a lower risk of SSI was reported in thyroid and parathyroid and nonmajor procedures ( P < .05 each). Other factors associated with a higher risk of SSI included multiple comorbidities, smoking, cancer diagnosis, concomitant neck dissection, and tracheostomy ( P < .05 each). SSI was associated with a mean ± SE additional hospital stay of 8.1 ± 0.8 days per case ( P < .001) and an additional cost on the health system of $20,953.00 ± $186.3 per case ( P < .001). Conclusions SSI is associated with a significant mortality risk and burden on the health system. More than half of SSI cases were identified on readmission.

scholarly journals Factors affecting wound complications in head and neck surgery: A prospective study

2013 ◽  
Vol 34 (4) ◽  
pp. 247 ◽  
Author(s):  
AnujaD Deshmukh ◽  
Tanveer Majeed ◽  
Pankaj Chaturvedi ◽  
Prathamesh Pai ◽  
AnilK D′cruz ◽  
...  
Keyword(s):  
Prospective Study ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Wound Complications ◽  
Factors Affecting ◽  
A Prospective Study

Cefotaxime prophylaxis in major non-contaminated head and neck surgery: one-dayvs.seven-day therapy

1993 ◽  
Vol 107 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Erkan Mustafa ◽  
Aslan Tahsin
Keyword(s):  
Antibiotic Prophylaxis ◽  
Wound Infection ◽  
Head And Neck ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Major Surgery ◽  
Double Blind Study ◽  
Antibiotic Administration ◽  
Double Blind ◽  
Perioperative Antibiotic Prophylaxis

AbstractPatients who undergo major surgery of head and neck benefit from perioperative antibiotic prophylaxis. This study was developed to determine if seven days of antibiotic administration would be more effective than one day. A prospective randomized double blind study was designed. Patients were randomly assigned to receive cefotaxime sodium for either 24 hours or seven days. In each case, the drug was administered intramuscularly, beginning one to two hours pre-operatively and continued for the prescribed period. Sixty patients were included in the trial. Of 30 patients assigned to one day of perioperative prophylaxis, wound infection developed in four (13 per cent). Of 30 patients assigned to seven days of perioperative antibiotic prophylaxis, wound infection developed in three (10 per cent) (P>0.05). These data suggest that no beneficial effect from administration of antibiotics for longer than 24 hours post-operatively can be achieved in patients who undergo major head and neck surgery.

Cephazolin and metronidazole prophylaxis in head and neck surgery

1997 ◽  
Vol 111 (7) ◽  
pp. 631-634 ◽  
Author(s):  
Melvin Strauss ◽  
Phillip W. Saccogna ◽  
Allan L. Allphin
Keyword(s):  
Head And Neck ◽  
Radical Neck Dissection ◽  
Wound Complication ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Wound Complications ◽  
Flap Reconstruction ◽  
Common Complication ◽  
Factors Associated ◽  
Clean Contaminated

AbstractA seven-day course of cephazolin and metronidazole chemoprophylaxis for clean-contaminated head and neck oncological procedures is compared to results with previously published antibiotic regimens. Aetiological factors associated with increased rates of wound complications are analyzed. Retrospective analysis of procedures over asix-year period was performed. The overall wound complication rate was 28.1 per cent, comparing favourably with previously published results. A major fistula was the most common complication with a rate of 9.2 per cent. Factors statistically associated with increased rates of wound complications included: radical neck dissection, extended surgical procedures requiring flap reconstruction, previous tracheotomy, and race. This is the largest single institutional study to show thata seven-day course of cephazolin and metronidazole is an effective chemoprophylactic regimen in head and neck surgery.

Determination of the Duration of Preoperative Smoking Cessation to Improve Wound Healing after Head and Neck Surgery

2005 ◽  
Vol 102 (5) ◽  
pp. 892-896 ◽  
Author(s):  
Michioki Kuri ◽  
Masashi Nakagawa ◽  
Hideo Tanaka ◽  
Seiko Hasuo ◽  
Yoshihiko Kishi
Keyword(s):  
Wound Healing ◽  
Smoking Cessation ◽  
Head And Neck ◽  
Confidence Intervals ◽  
Time History ◽  
Operation Time ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Wound Complications ◽  
Impaired Wound Healing

Background Preoperative smoking cessation has been suggested to be effective in reducing various postoperative complications. However, the optimal duration of preoperative smoking cessation for reducing wound complications is unclear. Methods One hundred eighty-eight consecutive patients who underwent reconstructive head and neck surgery at the authors' institution were included in this retrospective study. Information on preoperative smoking habits was obtained from the patients' medical records. Smokers were defined as having smoked within 7 days before surgery. Late, intermediate, and early quitters were defined as patients whose duration of abstinence from smoking was 8-21, 22-42, and 43 days or longer before the operation, respectively. Patients who required postoperative debridement, resuture, or reconstruction of their flap before hospital discharge were defined as having had impaired wound healing. Results The incidences (95% confidence intervals) of impaired wound healing among the late, intermediate, and early quitters and nonsmokers were 67.6% (52-83%), 55.0% (33-77%), 59.1% (47-71%), and 47.5% (32-63%), respectively, and the incidence of impaired wound healing was significantly lower among the intermediate quitters, early quitters, and nonsmokers than among the smokers (85.7% [73-97%]). After controlling for sex, age, American Society of Anesthesiologists physical status, operation time, history of diabetes mellitus, chemotherapy, radiation therapy, and the type of flap, the odds ratios (95% confidence intervals) for development of impaired wound healing in the late, intermediate, early quitters, and nonsmokers were 0.31 (0.08-1.24), 0.17 (0.04-0.75), 0.17 (0.05-0.60), and 0.11 (0.03-0.51), respectively, compared with the smokers. Conclusions Preoperative smoking abstinence of longer than 3 weeks reduces the incidence of impaired wound healing among patients who have undergone reconstructive head and neck surgery.

Sign in / Sign up

Export Citation Format

Share Document