Document Detail


Prophylactic antibiotics for head and neck surgery with flap reconstruction.
MedLine Citation:
PMID:  1571118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The leading cause of postoperative morbidity in patients undergoing major head and neck surgical procedures is postoperative infection. This prospective randomized multi-institutional clinical trial was designed to compare the effectiveness of clindamycin phosphate and high-dose cefazolin sodium therapy in preventing postoperative wound sepsis in patients undergoing contaminated head and neck surgical procedures in which flap reconstruction was required. Either clindamycin phosphate (900 mg) or cefazolin sodium (2 g) therapy was instituted intravenously prior to surgery and continued every 8 hours, for a total of 24 hours. The patients received postoperative follow-up, and the wounds were graded according to the worst condition observed. One hundred cases were evaluated. Fifty-one patients received clindamycin and 49 patients received high doses of cefazolin; wound infection developed in 10 patients (19.6%) and 11 patients (21.6%), respectively. This difference was not statistically significant. The average duration of surgery was approximately 8 hours for both the infected and the noninfected groups of patients. High-dose cefazolin and clindamycin have similar efficacy when administered prophylactically under these circumstances. Reconstruction with free vascularized tissue may aid in reducing postoperative wound infection.
Authors:
J T Johnson; R L Wagner; D E Schuller; J Gluckman; J Y Suen; N L Snyderman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of otolaryngology--head & neck surgery     Volume:  118     ISSN:  0886-4470     ISO Abbreviation:  Arch. Otolaryngol. Head Neck Surg.     Publication Date:  1992 May 
Date Detail:
Created Date:  1992-06-01     Completed Date:  1992-06-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8603209     Medline TA:  Arch Otolaryngol Head Neck Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  488-90     Citation Subset:  AIM; IM    
Affiliation:
University of Pittsburgh School of Medicine, Department of Otolaryngology, Eye and Ear Institute of Pittsburgh, PA.
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MeSH Terms
Descriptor/Qualifier:
Cefazolin / administration & dosage,  therapeutic use*
Clindamycin / therapeutic use*
Double-Blind Method
Head and Neck Neoplasms / surgery*
Humans
Prospective Studies
Surgical Flaps*
Surgical Wound Infection / prevention & control*
Chemical
Reg. No./Substance:
18323-44-9/Clindamycin; 25953-19-9/Cefazolin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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