Incidence And Risk Factors Associated with Surgical Site Infection in Oral Squamous Cell Carcinoma Patients-A Single- Center Prospective Study

Abstract

Introduction: Surgical management for head and neck cancer frequently entails a multi-step, intricate process that includes substantial resections, significant neck dissection and vascularised tissue repair. Surgical site infection (SSI) is a significant complication arising in patients undergone surgery for oral squamous cell carcinoma, impacting recovery and clinical outcomes. Our objective is to evaluate the prevalence of surgical site infection (SSI) and the risk variables related to it in patients who have undergone major surgery for head and neck cancer. Materials and methods: This is a prospective observational study which included 60 patients who underwent surgery. Surgical procedure included wide local excision, neck dissection with or without flap reconstruction. All the patients received intravenous antibiotics cephalosporins and metronidazole for 5 days postoperatively, and were observed for minimum of 30 days for any postoperative infection. Patient demographics, clinical data, perioperative variables were collected including age, sex, tumor stage, comorbidities, surgical procedure, history of prior radiotherapy, duration of surgery and postoperative care. The incidence of SSI was recorded and potential risk factors were analyzed. Results and discussion: In our study patient’s average age is 56.13±8.90 years. Twenty of the sixty patients developed surgical site infection (SSI). Tumour stage, ASA classification and the occurrence of surgical site infections are statistically correlated. The majority of individuals have tumours in advanced stage- IV. Although, the development of surgical site infections and tumour stage do not correlate statistically (p=0.120) but higher stage of disease have poor prognosis and predispose to SSI. Prior radiotherapy and tracheostomy shows no statistical correlation. However, Reconstruction with flap is statistically significant with Surgical site infection (p=0.016). Conclusion: After obtaining results, it is concluded that incidence of SSI remains a concern, with multiple factors contributing to infection risk. Early identification and targeted management of patients having comorbidities, undergone radiotherapy and planned for reconstruction can help reduce the incidence of surgical site infection and improve surgical outcomes.