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Indian Journal of Medical and Paediatric Oncology
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Year : 2013  |  Volume : 34  |  Issue : 4  |  Page : 247-251

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

1 Department of Head & Neck Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
2 Joy Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Anuja D Deshmukh
Department of Head & Neck Oncology, Tata Memorial Centre, Dr. E. Borges Road, Parel, Mumbai - 400 012, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-5851.125236

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Context: Head and neck surgeries are complex. Wound complications are associated with considerable morbidity and can result in delay in the adjuvant treatment. Identification of factors will help in formulating preventive guidelines. Aims: The aim of this study is to identify perioperative factors responsible for wound complications. Settings and Design: Prospective study of 186 head and neck patients. Subjects and Methods: Pre-operative, intraoperative and post-operative factors were recorded. Each patient was evaluated for minor and major wound complications twice daily during the hospital stay. Statistical Analysis: Chi-square test was used for univariate and log regression test was used for multivariate analysis. Results: The overall wound complication rate was 29% with 7% major and 22% minor complications. On univariate analysis, laryngeal and hypopharyngeal location, advanced T stage, poor oral hygiene, clean-contaminated surgery, low Karnofsky performance status (KPS), flap reconstruction, blood loss more than 1000 ml, perioperative blood transfusion, duration of surgery greater than 4.3 h and post-operative hemoglobin lesser than 11 g%, post-operative tracheostomy and resection of mandible were statistical significant factors. On multivariate analysis, post-operative tracheostomy, low KPS, post-operative serum albumin less than 3.7 g/dl and duration of surgery greater than 4.3 h were significant factors. Conclusion : Apart from unavoidable factors, it is essential to take care of certain factors viz nutrition, haemoglobin, oral hygiene, asepsis and repeating antibiotics in prolonged surgery.

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