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Determination of contamination of operation field in head and neck oncological surgery Authors: Maciej Mazurek Filip Nowakowski Artur Włodarczyk Michał.

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Presentation on theme: "Determination of contamination of operation field in head and neck oncological surgery Authors: Maciej Mazurek Filip Nowakowski Artur Włodarczyk Michał."— Presentation transcript:

1 Determination of contamination of operation field in head and neck oncological surgery Authors: Maciej Mazurek Filip Nowakowski Artur Włodarczyk Michał Głuski Head and Neck Cancer Clinic of Marie Sklodowka Curie Memorial Cancer Centre – Institute Head: Prof., Andrzej Kawecki Ph.D. Tutors: Janusz Jaworowski M.D., Maciej Rysz M.D. Students' Scientific Group attached to Head and Neck Cancer Clinic

2 Background: Surgical resections of head and neck cancer with one-stage reconstructions are long procedures with high risk of microbial contamination; Determination of contaminating factors and efficacy of aseptic procedures is vital for reduction of possible surgical complications.

3 Aim: Define possible complications Determinate contaminating factor Improve treatment Aim of this study is to determinate amount and type of the surgical field contamination factors and to define possible complications that can occur after resection of advanced tumour of head and neck.

4 Materials and Methods Swabs were taken from surgical field and surgical drapes every 2 hours (at 0h, 2h, 4h, 6h); Samples were delivered to the laboratory immediately; To analize our results we have used Statistica. The prospective study, which was approved by Bioethical Committee; The study was performed during long time surgical resections with one-stage reconstruction;

5 Materials and Methods Microbial culturing methods: Blood agar plate – preliminary culturing (24-48 h, 37 Degrees Centigrade, CO2 enhanced atmosphere if needed); CPS agar, Chapman agar – differential culturing (24h, 37 Degrees Centigrade); Final identification and antibiogram: ATB, API, VITEK Culturing methods and microbial diagnostics:

6 Results : Comparison of infected samples in time relevance: 39 out of 40 patients included to the research; 252 samples 188 contaminated (74,6% contaminated).

7 Results: contaminated samples 4-6h and over 6h Surgeries.

8 Results: contaminated samples 4-6h and over 6h Surgeries.

9 Results: infected samples Comparison of the most common pathogenes : One sample could be infected by more than one pathogene These pathogenes were the most popular outcome.

10 Results: antibiogram AntibioticNumber of tested samples Determinated resistancy Amoxicillin and Clavulanic acid 221 Penicillin110 Clindamicin233 Vancomicin160 Ciprofloxacin201 Ceftriaxone162 Tetracycline197 Gentamicin214

11 Results: complications 2 abscesses (5%) 1.)One abscess caused by streptococcal infection. 2.) One abscess caused by inapprioprate hygiene of the patient Related with the contamination in 6 cases (15%) 1.)Heamorrhage (1) 2.)Heamatoma (1) 3.)Fistulas (3) 4.) Partial necrosis (1) Unrelated with the contamination Complications after surgeries occured in 8 out of 40 cases (20%).

12 Conclusions: The number of infected samples from surgical field was not constantly increasing in time during surgeries; Peak of the contaminations was observed in 2nd hour, in timing of finishing tumour resection; Most common pathogenes were: Str. spp, Staph. Coagulasis(-) and Propionibacterium acnes; In spite of observing standard asepsis rules contamination of the surgical field occurs frequently.

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