Universität zu Köln

Zirk, Matthias, Zalesski, Artjom, Peters, Franziska, Dreiseidler, Timo, Buller, Johannes, Kreppel, Matthias, Zoeller, Joachim E. and Zinser, Max (2018). Prevention and management of bacterial infections of the donor site of flaps raised for reconstruction in head and neck surgery. J. Cranio-MaxilloFac. Surg., 46 (9). S. 1669 - 1674. EDINBURGH: CHURCHILL LIVINGSTONE. ISSN 1878-4119

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Abstract

Purpose: In the field of reconstructive head and neck surgery, surgical site infections (SSI) are commonly investigated for the recipient site of various reconstructive procedures. Data about SSI of the donor site of different flaps raised for reconstruction are rare. Material and Methods: With regard to the bacterial donor site infections, we retrospectively investigated the medical data, surgical reports and wound management protocols of 267 patients who received reconstruction of the head and neck after ablative surgery. All patients underwent reconstruction with one of the following flaps: free fasciocutaneous radial forearm flap (RFFF), free fasciocutaneous anterolateral thigh flap (ALTFF), pedicled myocutaneous latissimus dorsi flap (PLDF), pedicled myocutaneous pectoralis major flap (PPMF), free osteocutaneous fibula flap (FFF). Follow-up was conducted for 12 months. Results: The lowest detection ratio (DR: number of infected sites/flaps raised from the respective donor site) was calculated for the radial forearm, 0.087. Pedicled flaps presented a moderate DR (PLDF: 0.27, PMMF:0.35). Donor sites of the leg possessed the highest DR (ALTFF:0.61, FFF: 045). Mainly gram-positive facultative anaerobic bacteria (n = 41) were detected and gram-negative bacteria (aerobe/anaerobe) were present in 27 cases. The most frequently detected bacteria were Staphylococcus spp., Viridans Streptococci, Pseudomonas aeruginosa and Escheria coli. Continuous wound management for in-hospital patients was able to prevent any local spreading or a prolonged length of in-hospital stay. Conclusion: Overall, gram-positive facultative anaerobic bacteria, mainly Staphylococcus spp., are the predominant bacteria detected in donor site wounds. For wound care management, an infection with gram-negative pathogens should not be neglected. (C) 2018 Published by Elsevier Ltd on behalf of European Association for Cranio-Maxillo-Facial Surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Zirk, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Zalesski, Artjom UNSPECIFIED UNSPECIFIED UNSPECIFIED Peters, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Dreiseidler, Timo UNSPECIFIED UNSPECIFIED UNSPECIFIED Buller, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreppel, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Zoeller, Joachim E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zinser, Max UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-175166
DOI:	10.1016/j.jcms.2018.06.011
Journal or Publication Title:	J. Cranio-MaxilloFac. Surg.
Volume:	46
Number:	9
Page Range:	S. 1669 - 1674
Date:	2018
Publisher:	CHURCHILL LIVINGSTONE
Place of Publication:	EDINBURGH
ISSN:	1878-4119
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RESISTANT PSEUDOMONAS-AERUGINOSA; LATISSIMUS-DORSI FLAP; ANTIBIOTIC-PROPHYLAXIS; DELAYED PRIMARY; MORBIDITY; CLOSURE Multiple languages Dentistry, Oral Surgery & Medicine; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/17516