Preoperative topical antimicrobial decolonization in head and neck surgery
dc.contributor.author | Shuman, Andrew G. | en_US |
dc.contributor.author | Shuman, Emily K. | en_US |
dc.contributor.author | Hauff, Samantha J. | en_US |
dc.contributor.author | Fernandes, Laura L. | en_US |
dc.contributor.author | Light, Emily | en_US |
dc.contributor.author | Chenoweth, Carol E. | en_US |
dc.contributor.author | Bradford, Carol R. | en_US |
dc.date.accessioned | 2012-11-07T17:04:31Z | |
dc.date.available | 2014-01-07T14:51:07Z | en_US |
dc.date.issued | 2012-11 | en_US |
dc.identifier.citation | Shuman, Andrew G.; Shuman, Emily K.; Hauff, Samantha J.; Fernandes, Laura L.; Light, Emily; Chenoweth, Carol E.; Bradford, Carol R. (2012). "Preoperative topical antimicrobial decolonization in head and neck surgery ." The Laryngoscope 122(11): 2454-2460. <http://hdl.handle.net/2027.42/94244> | en_US |
dc.identifier.issn | 0023-852X | en_US |
dc.identifier.issn | 1531-4995 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/94244 | |
dc.description.abstract | Objectives/Hypothesis: Surgical site infections (SSIs) are an important cause of morbidity and mortality after head and neck surgery. Our primary objective was to determine the efficacy of preoperative topical antimicrobial decolonization before head and neck surgery. Study Design: Prospective, randomized controlled trial. Methods: This study was conducted among 84 patients presenting for head and neck surgery requiring admission to an academic medical center. Preoperative cultures were performed to identify Staphylococcus aureus carriers. Patients were randomized to preoperative topical antimicrobial decolonization with a 5‐day regimen of chlorhexidine skin rinses and intranasal mupirocin coupled with standard perioperative systemic antimicrobial prophylaxis, versus standard prophylaxis alone. The main outcome was the incidence of SSIs. Results: Despite a trend suggesting a decrease in SSIs with perioperative topical antimicrobial decolonization (24% vs. 10%), there was no significant difference (odds ratio, 0.34; 95% confidence interval, 0.10–1.18; P = .079). Patients with a higher American Society of Anesthesiologists score (3 vs. 1; P = .02), with more operative blood loss ( P = .05), and who required operative takeback ( P = .04) had a higher rate of SSIs; there was a trend suggesting a higher rate of SSIs among patients undergoing clean‐contaminated surgery compared to clean cases ( P = .08) and among those having received prior radiation ( P = .07) or chemotherapy ( P = .06). Conclusions: Preoperative antimicrobial decolonization did not significantly decrease the incidence of SSIs after head and neck surgery, but might be considered for high‐risk groups despite the lack of conclusive evidence confirming efficacy. Risk factors for SSIs after head and neck surgery are identified for the first time in a prospective study. Laryngoscope, 2012 | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Level of Evidence: 1b | en_US |
dc.subject.other | Surgical Site Infection | en_US |
dc.subject.other | Antimicrobial Decolonization | en_US |
dc.subject.other | Head and Neck Surgery | en_US |
dc.title | Preoperative topical antimicrobial decolonization in head and neck surgery | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Otolaryngology | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Infection Control and Epidemiology, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A. | en_US |
dc.contributor.affiliationum | University of Michigan Comprehensive Cancer Center, Biostatistics Core, Ann Arbor, Michigan, U.S.A. | en_US |
dc.contributor.affiliationum | Internal Medicine, Division of Infectious Disease, University of Michigan Medical School, Ann Arbor, Michigan, U.S.A. | en_US |
dc.contributor.affiliationum | Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, U.S.A. | en_US |
dc.contributor.affiliationum | Department of Otolaryngology–Head and Neck Surgery, University of Michigan Hospitals, 1904 Taubman Center, Ann Arbor, MI 48109 | en_US |
dc.contributor.affiliationother | Departments of Otolaryngology–Head and Neck Surgery, Ann Arbor, Michigan, U.S.A. | en_US |
dc.identifier.pmid | 22865589 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/94244/1/23487_ftp.pdf | |
dc.identifier.doi | 10.1002/lary.23487 | en_US |
dc.identifier.source | The Laryngoscope | en_US |
dc.identifier.citedreference | Miyake M, Ohbayashi Y, Iwasaki A, Ogawa T, Nagahata S. Risk factors for methicillin‐resistant Staphylococcus aureus (MRSA) and use of a nasal mupirocin ointment in oral cancer inpatients. J Oral Maxillofac Surg 2007; 65: 2159 – 2163. | en_US |
dc.identifier.citedreference | Sutherland R, Boon RJ, Griffin KE, Masters PJ, Slocombe B, White AR. Antibacterial activity of mupirocin (pseudomonic acid), a new antibiotic for topical use. Antimicrob Agents Chemother 1985; 27: 495 – 498. | en_US |
dc.identifier.citedreference | Milstone AM, Passaretti CL, Perl TM. Chlorhexidine: expanding the armamentarium for infection control and prevention. Clin Infect Dis 2008; 46: 274 – 281. | en_US |
dc.identifier.citedreference | Bode LG, Kluytmans JA, Wertheim HF, et al. Preventing surgical‐site infections in nasal carriers of Staphylococcus aureus. N Engl J Med 2010; 362: 9 – 17. | en_US |
dc.identifier.citedreference | van Rijen M, Bonten M, Wenzel R, Kluytmans J. Mupirocin ointment for preventing Staphylococcus aureus infections in nasal carriers. Cochrane Database Syst Rev 2008 ( 4 ): CD006216. | en_US |
dc.identifier.citedreference | van Rijen MM, Bonten M, Wenzel RP, Kluytmans JA. Intranasal mupirocin for reduction of Staphylococcus aureus infections in surgical patients with nasal carriage: a systematic review. J Antimicrob Chemother 2008; 61: 254 – 261. | en_US |
dc.identifier.citedreference | Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev 2007 ( 2 ): CD004985. | en_US |
dc.identifier.citedreference | Hebert C, Robicsek A. Decolonization therapy in infection control. Curr Opin Infect Dis 2010; 23: 340 – 345. | en_US |
dc.identifier.citedreference | Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20: 250 – 278; quiz 279 – 280. | en_US |
dc.identifier.citedreference | Dellinger EP, Gross PA, Barrett TL, et al. Quality standard for antimicrobial prophylaxis in surgical procedures. The Infectious Diseases Society of America. Infect Control Hosp Epidemiol 1994; 15: 182 – 188. | en_US |
dc.identifier.citedreference | Horan TC, Andrus M, Dudeck MA. CDC/NHSN surveillance definition of health care‐associated infection and criteria for specific types of infections in the acute care setting. Am J Infect Control 2008; 36: 309 – 332. | en_US |
dc.identifier.citedreference | Simmons RL. Wound infection: a review of diagnosis and treatment. Infect Control 1982; 3: 44 – 51. | en_US |
dc.identifier.citedreference | Dripps RD, Lamont A, Eckenhoff JE. The role of anesthesia in surgical mortality. JAMA 1961; 178: 261 – 266. | en_US |
dc.identifier.citedreference | ASA Physical Status Classification System. Available at: http://www.asahq.org/clinical/physicalstatus.htm Accessed June 3, 2011. | en_US |
dc.identifier.citedreference | Que Y, Moreillon P. Staphylococcus aureus. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Bennett, and Dolin's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier; 2009. | en_US |
dc.identifier.citedreference | Buehlmann M, Frei R, Fenner L, Dangel M, Fluckiger U, Widmer AF. Highly effective regimen for decolonization of methicillin‐resistant Staphylococcus aureus carriers. Infect Control Hosp Epidemiol 2008; 29: 510 – 516. | en_US |
dc.identifier.citedreference | Perl TM, Cullen JJ, Wenzel RP, et al. Intranasal mupirocin to prevent postoperative Staphylococcus aureus infections. N Engl J Med 2002; 346: 1871 – 1877. | en_US |
dc.identifier.citedreference | Harbarth S, Fankhauser C, Schrenzel J, et al. Universal screening for methicillin‐resistant Staphylococcus aureus at hospital admission and nosocomial infection in surgical patients. JAMA 2008; 299: 1149 – 1157. | en_US |
dc.identifier.citedreference | Morimoto Y, Sugiura T, Tatebayashi S, Kirita T. Reduction in incidence of methicillin‐resistant Staphylococcus aureus (MRSA) after radical surgery for head and neck cancer. Spec Care Dentist 2006; 26: 209 – 213. | en_US |
dc.identifier.citedreference | Watters K, O'Dwyer TP, Rowley H. Cost and morbidity of MRSA in head and neck cancer patients: what are the consequences? J Laryngol Otol 2004; 118: 694 – 699. | en_US |
dc.identifier.citedreference | Ringberg H, Cathrine Petersson A, Walder M, Hugo Johansson PJ. The throat: an important site for MRSA colonization. Scand J Infect Dis 2006; 38: 888 – 893. | en_US |
dc.identifier.citedreference | Lautenbach E, Nachamkin I, Hu B, et al. Surveillance cultures for detection of methicillin‐resistant Staphylococcus aureus: diagnostic yield of anatomic sites and comparison of provider‐ and patient‐collected samples. Infect Control Hosp Epidemiol 2009; 30: 380 – 382. | en_US |
dc.identifier.citedreference | Garibaldi RA, Cushing D, Lerer T. Predictors of intraoperative‐acquired surgical wound infections. J Hosp Infect 1991; 18 ( suppl A ): 289 – 298. | en_US |
dc.identifier.citedreference | Korinek AM, Golmard JL, Elcheick A, et al. Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4,578 patients. Br J Neurosurg 2005; 19: 155 – 162. | en_US |
dc.identifier.citedreference | Lee DH, Kim SY, Nam SY, Choi SH, Choi JW, Roh JL. Risk factors of surgical site infection in patients undergoing major oncological surgery for head and neck cancer. Oral Oncol 2011; 47: 528 – 531. | en_US |
dc.identifier.citedreference | Rodrigo JP, Alvarez JC, Gomez JR, Suarez C, Fernandez JA, Martinez JA. Comparison of three prophylactic antibiotic regimens in clean‐contaminated head and neck surgery. Head Neck 1997; 19: 188 – 193. | en_US |
dc.identifier.citedreference | Skitarelic N, Morovic M, Manestar D. Antibiotic prophylaxis in clean‐contaminated head and neck oncological surgery. J Craniomaxillofac Surg 2007; 35: 15 – 20. | en_US |
dc.identifier.citedreference | Redleaf MI, Bauer CA. Topical antiseptic mouthwash in oncological surgery of the oral cavity and oropharynx. J Laryngol Otol 1994; 108: 973 – 979. | en_US |
dc.identifier.citedreference | Simons JP, Johnson JT, Yu VL, et al. The role of topical antibiotic prophylaxis in patients undergoing contaminated head and neck surgery with flap reconstruction. Laryngoscope 2001; 111: 329 – 335. | en_US |
dc.identifier.citedreference | Fawley WN, Parnell P, Hall J, Wilcox MH. Surveillance for mupirocin resistance following introduction of routine peri‐operative prophylaxis with nasal mupirocin. J Hosp Infect 2006; 62: 327 – 332. | en_US |
dc.identifier.citedreference | Lee AS, Macedo‐Vinas M, Francois P, et al. Impact of combined low‐level mupirocin and genotypic chlorhexidine resistance on persistent methicillin‐resistant Staphylococcus aureus carriage after decolonization therapy: a case‐control study. Clin Infect Dis 2011; 52: 1422 – 1430. | en_US |
dc.identifier.citedreference | Phan M, Van der Auwera P, Andry G, et al. Antimicrobial prophylaxis for major head and neck surgery in cancer patients: sulbactam‐ampicillin versus clindamycin‐amikacin. Antimicrob Agents Chemother 1992; 36: 2014 – 2019. | en_US |
dc.identifier.citedreference | Penel N, Fournier C, Lefebvre D, Lefebvre JL. Multivariate analysis of risk factors for wound infection in head and neck squamous cell carcinoma surgery with opening of mucosa. Study of 260 surgical procedures. Oral Oncol 2005; 41: 294 – 303. | en_US |
dc.identifier.citedreference | Dellinger EP, Ehrenkranz NJ, Jarvis WR. Surgical site infections. In: Jarvis WR, ed. Bennett and Brachman's Hospital Infections. Philadelphia, PA: Lippincott, Williams, and Wilkins; 2007: 583 – 598. | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
Files in this item
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.