Impact of perioperative oral care on postoperative infections in patients with head and neck cancer: A retrospective study comparing before and during the coronavirus disease 2019 pandemic

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

Auris Nasus Larynx Pub Date : 2025-12-01 Epub Date: 2025-10-22 DOI:10.1016/j.anl.2025.10.003

Azusa Kai , Kimie Fujita , Naohisa Wada , Takashi Nakagawa

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引用次数: 0

Abstract

Objective

Infection prevention is crucial in head and neck cancer surgery due to the high risk of surgical site contamination by oral bacteria and pharyngeal secretions. The coronavirus disease 2019 (COVID-19) pandemic has introduced significant challenges to infection control in medical settings, including restrictions on patient care and changes to perioperative management. This study investigated the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) before and during the COVID-19 pandemic, and examined how perioperative oral care and oral hygiene status were associated with the occurrence of postoperative infections.

Methods

We retrospectively reviewed the medical records of patients who underwent head and neck cancer surgery between January 2018 and March 2022. The incidences of PP and SSI were compared before and during the COVID-19 pandemic. In addition, variables identified by univariate analysis as predictors of postoperative infection were incorporated and examined using logistic regression analysis.

Results

A total of 213 patients were included in this study. The incidence rates of PP and SSI were 15.0% and 24.4%, respectively, with no statistically significant difference before and during the pandemic. The risk factors for PP included preoperative oral dryness (odds ratio [OR] = 2.65; 95% confidence interval [CI] = 1.14–6.17; p = 0.024), and diabetes (OR = 2.65; 95% CI = 1.04–6.72; p = 0.040), while for SSI, the risk factors included lack of postoperative oral care (OR = 0.29; 95% CI = 0.10–0.86; p = 0.026), prolonged operative time (OR = 1.80; 95% CI = 1.09–2.99; p = 0.022), and preoperative radiotherapy (OR = 2.25; 95% CI = 1.02–4.95; p = 0.044).

Conclusion

Appropriate perioperative oral care remains essential, even in the post-COVID-19 era. This study highlights the importance of preventing oral dryness before surgery and ensuring continuous professional oral care before and after surgery to prevent postoperative infections.

查看原文本刊更多论文

围手术期口腔护理对头颈癌患者术后感染的影响：2019冠状病毒病大流行前后的回顾性研究

目的：口腔细菌和咽分泌物极易污染头颈部肿瘤手术部位，因此预防感染是头颈部肿瘤手术的关键。2019年冠状病毒病（COVID-19）大流行给医疗环境中的感染控制带来了重大挑战，包括对患者护理的限制和围手术期管理的改变。本研究调查了2019冠状病毒病大流行前和期间患者术后肺炎（PP）和手术部位感染（SSI）的发生率，并探讨围手术期口腔护理和口腔卫生状况与术后感染发生的关系。方法：回顾性分析2018年1月至2022年3月期间接受头颈癌手术患者的医疗记录。比较新冠肺炎大流行前后PP和SSI的发生率。此外，通过单变量分析确定的预测术后感染的变量被纳入并使用逻辑回归分析进行检验。结果：本研究共纳入213例患者。PP和SSI的发病率分别为15.0%和24.4%，大流行前和大流行期间差异无统计学意义。PP的风险因素包括术前口腔干燥(优势比[或]= 2.65;95%可信区间[CI] = 1.14 - -6.17; p = 0.024),和糖尿病(OR = 2.65; 95%可信区间-6.72 = 1.04;p = 0.040),而对于SSI,风险因素包括缺乏术后口腔护理(OR = 0.29; 95%可信区间-0.86 = 0.10;p = 0.026),延长手术时间(OR = 1.80; 95%可信区间-2.99 = 1.09;p = 0.022),和术前放疗(OR = 2.25; 95%可信区间-4.95 = 1.02;p = 0.044)。结论：即使在后covid -19时代，适当的围手术期口腔护理仍然至关重要。本研究强调了术前预防口腔干燥的重要性，并确保术前和术后持续的专业口腔护理，以防止术后感染。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.