Efficacy of Cefazolin as a Prophylactic Antibiotic in Head and Neck Surgery

The rationale for use of perioperative short-term prophylactic antibiotics in prevention of postoperative infection in major head and neck surgery was reviewed. Cefazolin and placebo were compared in 50 patients and results showed that short-term perioperative cefazolin was a useful adjunct in reduction of postoperative infection. Findings suggest perioperative antibiotics may be safely and effectively used to reduce postoperative morbidity from infection after surgical procedures involving skin and mucosa of the upper aero-digestive tract.

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Short-term versus long-term antimicrobial prophylaxis in oncologic head and neck surgery

Head & Neck ◽

10.1002/(sici)1097-0347(199609/10)18:5<399::aid-hed2>3.0.co;2-0 ◽

1996 ◽

Vol 18 (5) ◽

pp. 399-404 ◽

Cited By ~ 39

Author(s):

Mauro Righi ◽

Roberto Manfredi ◽

Giovanni Farneti ◽

Ernesto Pasquini ◽

Vittorio Cenacchi

Keyword(s):

Head And Neck ◽

Antimicrobial Prophylaxis ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Short Term

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EFFECT OF PROPHYLACTIC ANTIBIOTICS IN RADICAL HEAD AND NECK SURGERY

The Laryngoscope ◽

10.1288/00005537-197904000-00009 ◽

1979 ◽

Vol 89 (4) ◽

pp. 600???608

Author(s):

RICHARD L. GOODB ◽

NORTON ABRAMSON ◽

WILLARD E. FEB ◽

PAUL LEVINE

Keyword(s):

Head And Neck ◽

Neck Surgery ◽

Prophylactic Antibiotics ◽

Head And Neck Surgery

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A Meta-Analysis of Prophylactic Antibiotics in Head and Neck Surgery

Plastic & Reconstructive Surgery ◽

10.1097/00006534-199103000-00007 ◽

1991 ◽

Vol 87 (3) ◽

pp. 435

Author(s):

Vic Velanovich ◽

Neal Koss

Keyword(s):

Head And Neck ◽

Meta Analysis ◽

Neck Surgery ◽

Prophylactic Antibiotics ◽

Head And Neck Surgery

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Current Evidence regarding Prophylactic Antibiotics in Head and Neck and Maxillofacial Surgery

BioMed Research International ◽

10.1155/2014/879437 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 17

Author(s):

Kilian Kreutzer ◽

Katharina Storck ◽

Jochen Weitz

Keyword(s):

Antibiotic Prophylaxis ◽

Head And Neck ◽

Maxillofacial Surgery ◽

Neck Region ◽

Neck Surgery ◽

Prophylactic Antibiotics ◽

Head And Neck Surgery ◽

Current Evidence ◽

High Level ◽

Meta Analyses

Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.

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Objective Assessment of Technical Skills in Otorhinolaryngology–Head and Neck Surgery Residents: A Systematic Review

Otolaryngology ◽

10.1177/0194599817729826 ◽

2017 ◽

Vol 158 (1) ◽

pp. 54-61 ◽

Cited By ~ 2

Author(s):

Érika Mercier ◽

Ségolène Chagnon-Monarque ◽

François Lavigne ◽

Tareck Ayad

Keyword(s):

Head And Neck ◽

Surgical Procedures ◽

Rating Scale ◽

Reliability And Validity ◽

Neck Surgery ◽

Evaluation Methods ◽

Head And Neck Surgery ◽

Assessment Tools ◽

Global Rating Scale ◽

Global Rating

Objectives The primary goal is the indexation of validated methods used to assess surgical competency in otorhinolaryngology–head and neck surgery (ORL-HNS) residents. Secondary goals include assessment of the reliability and validity of these tools, as well as the documentation of specific procedures in ORL-HNS involved. Data Sources MEDBASE, OVID, Medline, CINAHL, and EBM, as well as the printed references, available through the Université de Montréal library. Review Methods The PRISMA method was used to review digital and printed databases. Publications were reviewed by 2 independent reviewers, and selected articles were fully analyzed to classify evaluation methods and categorize them by procedure and subspecialty of ORL-HNS involved. Reliability and validity were assessed and scored for each assessment tool. Results Through the review of 30 studies, 5 evaluation methods were described and validated to assess the surgical competency of ORL-HNS residents. The evaluation method most often described was the combined Global Rating Scale and Task-Specific Checklist tool. Reliability and validity for this tool were overall high; however, considerable data were unavailable. Eleven distinctive surgical procedures were studied, encompassing many subspecialties of ORL-HNS: facial plastics, general ear-nose-throat, laryngology, otology, pediatrics, and rhinology. Conclusions Although assessment tools have been developed for an array of surgical procedures, involving most ORL-HNS subspecialties, the use of combined checklists has been repeatedly validated in the literature and shown to be easily applicable in practice. It has been applied to many ORL-HNS procedures but not in oncologic surgery to date.

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ONE DAY VS. TWO DAYS OF PROPHYLACTIC ANTIBIOTICS IN PATIENTS UNDERGOING MAJOR HEAD AND NECK SURGERY

The Laryngoscope ◽

10.1288/00005537-198405000-00006 ◽

1984 ◽

Vol 94 (5) ◽

pp. 612???614 ◽

Cited By ~ 33

Author(s):

WILLARD E. FEE ◽

MICHAEL GLENN ◽

CYNTHIA HANDEN ◽

MARTIN L. HOPP

Keyword(s):

Head And Neck ◽

Neck Surgery ◽

Prophylactic Antibiotics ◽

Head And Neck Surgery

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Haemostasis in head and neck surgical procedures: Valsalva manoeuvre versus Trendelenburg tilt

Annals of The Royal College of Surgeons of England ◽

10.1308/003588410x12664192076412 ◽

2010 ◽

Vol 92 (4) ◽

pp. 292-294 ◽

Cited By ~ 15

Author(s):

I Moumoulidis ◽

Martinez M Del Pero ◽

L Brennan ◽

P Jani

Keyword(s):

Head And Neck ◽

Surgical Procedures ◽

Tilt Angle ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Valsalva Manoeuvre ◽

Operating Table ◽

Trendelenburg Position ◽

Female Patients ◽

Intracranial Complications

INTRODUCTION The aim of the study was to identify whether Trendelenburg position helps detect any further bleeding points following Valsalva manoeuvre in order to achieve adequate haemostasis in head and neck surgery. PATIENTS AND METHODS Fifty consecutive patients undergoing major head and neck surgical procedures were included. The protocol consisted in performing Valsalva manoeuvre to check haemostasis and treated any bleeding points identified. The operating table was tilted 30° and haemostasis was checked again and treated accordingly. The number of vessels identified and the treatment was recorded. RESULTS Twelve male and 38 female patients were included. The median age was 53 years and 74% had an ASA of 1. Twelve patients had complicating features such as retrosternal extensions or raised T4 levels pre-operatively. Thyroid resections were the most common operations performed. The total number of bleeding vessels identified in Trendelenburg tilt was significantly greater than when using Valsalva manoeuvre (P < 0.0001). All bleeding points found on Valsalva manoeuvre were minor (< 2 mm) and dealt with using diathermy. In Trendelenburg position, 11% of bleeding vessels required ties or stitching. The time taken during Valsalva manoeuvre was 60 s on average and 360 s in Trendelenburg position. CONCLUSIONS The results show that the Trendelenburg position is vastly superior to the Valsalva manoeuvre in identifying bleeding vessels at haemostasis. It has become our practice to put patients in Trendelenburg tilt routinely (we have discontinued the Valsalva manoeuvre), to check its adequacy before closing the wound. We have not noticed any intracranial complications using a tilt angle of 30°.

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