부산대학교 도서관

Background: Surgical site infections (SSI) are one of the major complications and key prognosis factor in postoncologic head and neck cancer patients undergoing immediate reconstruction with free tissue transfer. Several studies have identified the risk factors for SSI, but little is known about how the use of drains affects postoperative infection signs and control. This study investigates the benefit of placing an additional open drain in the submandibular triangle, near the flap pedicle and away from the suction drain, to augment drainage. Methods: A two-year retrospective chart review of head and neck cancer patients who received immediate free flap reconstruction after tumour resection was performed. The experimental group consisted of patients with a closed suction drain and an additional open drain (AOD). The control group consisted of patients with only a close suction drain (CSD). Results: 469 patients met the inclusion criteria. The experimental group consisted of 292 patients and the control group of 177. Presence of postoperative fever was statistically significantly reduced in 8% of the experimental group (p=0.03). Clinical signs of infection were reduced in the experimental group, but were not statistically significant. Conclusion: A combined use of a closed suction drain in the posterior triangle of neck and an additional open drain in the submandibular triangle to augment drainage function in postoncologic head and neck cancer patients reconstructed with free tissue transfer is safe and decreases the postoperative incidence of fever by 8%.