Risk Factors of Surgical Site Infection After Total Laryngectomy

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BACKGROUND: The aim of this study is investigating the risk factors of postoperative surgical site infection (SSI) after total laryngectomy. We also examine if previous neck dissection was associated with an increased SSI rate in patients who underwent total laryngectomy.METHODS: We retrospectively reviewed over 800 chart records of laryngectomized patients from March 1994 to December 2010. Basic data along with relevant tumor and surgical variables were collected. The SSI rate was calculated and compared between those had previous neck dissection and those who did not. Chi-square test or Student's t-test was used to investigate the differences between patients with SSI and those without. Logistic regression model was applied to identify independent risk factors of SSI of patients after total laryngectomy.RESULTS: A total of 602 patients were enrolled for final analyses. The overall postoperative SSI rate was 37%. After adjusting for other variables, the independent risk factors associated with postoperative SSI after total laryngectomy included diabetes mellitus, preoperative radiotherapy, prolonged operative duration, peri-operative blood transfusion, postoperative serum albumin level ＜ 2.9 g/dl, and previous neck dissection. The SSI rate for patients who had previous neck dissection was higher than that for patients without previous neck dissection (odds ratio: 2.188, 95% confidence interval: 1.067~4.488, p = 0.033).CONCLUSIONS: Identification of the relevant factors may help surgeons determine which patients may be at high risk of developing postoperative SSI. Meticulous surgical technique and postoperative treatment are essential in patients with an increased risk of postoperative SSI.