J Cancer 2019; 10(1):205-210. doi:10.7150/jca.26298

Research Paper

Professional Oral Health Care at General Dental Clinic Reduces Postoperative Complications of Head and Neck Free-Flap Reconstruction Surgery

Masatoshi Usubuchi1✉, Kazuto Matsuura2, Takahiro Goto3, Yukinori Asada2, Takayuki Imai2, Takenori Ogawa4, Kengo Kato4, Shigeru Saijo2

1. Department of Dentistry, Miyagi Cancer Center
2. Department of Head and Neck Surgery, Miyagi Cancer Center
3. Department of Plastic and Reconstructive Surgery, Miyagi Cancer Center
4. Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine

Abstract

Background: Extensive resection and free-flap reconstruction surgery has become the standard treatment for locally advanced head and neck cancer. Surgical site infection (SSI) is one of the serious complications of this treatment. This study aimed to investigate the risk factor for onset of SSI, particularly focusing on whether preoperative professional oral health care in cooperation with general dental clinics is effective in reducing the occurrence of SSI.

Methods: From March 2003 to August 2011, 183 patients who underwent head and neck free-flap reconstructive surgery by the same plastic surgeon at Miyagi Cancer Center for Head and Neck Surgery were investigated retrospectively.

Results: Of the 183 patients, 135 and 48 were men and women, respectively, with a mean age of 62 (range, 29-82) years. The tumor was located in the oral cavity (n = 76), hypopharynx (n = 55), oropharynx (n = 28), and others (n = 24). Clinical stages were stage I/II in 18, stage III/IV in 164 patients, and benign tumor in one patient, based on UICC classification. SSI occurred in 66 patients (36.1%). Based on multivariate analysis, professional oral health care [P = 0.0076, odds ratio (OR) = 0.39] and radiation therapy history (P = 0.0214, OR = 2.820) were shown as factors that are significantly related to SSI.

Conclusion: This study identified history of radiation therapy as a significant risk factor for SSI from univariate and multivariate analysis and revealed that patients receiving preoperative professional oral health care at general dental clinics reduce the risk of SSI. Preoperative professional oral health care in cooperation with general dental clinics has been shown to reduce SSI of head and neck free-flap reconstructive surgery.

Keywords: Head and neck tumor, free-flap reconstructive surgery, Surgical site infection, Professional oral health care, Medical collaboration, general dental clinic

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How to cite this article:
Usubuchi M, Matsuura K, Goto T, Asada Y, Imai T, Ogawa T, Kato K, Saijo S. Professional Oral Health Care at General Dental Clinic Reduces Postoperative Complications of Head and Neck Free-Flap Reconstruction Surgery. J Cancer 2019; 10(1):205-210. doi:10.7150/jca.26298. Available from http://www.jcancer.org/v10p0205.htm