Delayed wound infection after supracricoid partial laryngectomy following failure of high dose radiation
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Meijin Nakayama Makito Okamoto Yutomo Seino Shunsuke Miyamoto Takashi Matsuki Akiko Ogawa
- چاپ و سال / کشور: 2011
Description
Past radiation therapy is known as a major risk factor promoting post-supracricoid partial laryngectomy (SCPL) complications. Risk of post-SCPL complications may further increase following failure of high dose radiation; in these patients, wound infection may become evident more than 1 month after an uneventful post-surgical course. By defining this complication as ‘‘Delayed Wound Infection’’ and reviewing the clinical features, we intended to elucidate the mechanism, risk factors, and management of this post-SCPL complication. Between 1997 and 2009, 60 patients received SCPL. The incidence of post-SCPL wound infection was analyzed in reflect to radiation status, radiation dose, and medical histories. Of 60 patients, delayed wound infection was identified in 4 (7%); radiation doses were 65, 68, 70, and 76.8 Gy (avg. 70 Gy). Blood data including white blood cell and C-reactive protein showed slight elevation before the delayed infection became evident. Patients with high dose radiation (C65 Gy) accompanied by histories of diabetes and renal insufficiency are considered a high risk group. Delayed reepithelialization of the inner surface of the cricohyoido gap was presumed to be the main pathogenesis. Early initiation of antibiotics and hyperbaric oxygen therapy are effective for rapid recovery. ‘‘Delayed Wound Infection’’ was treatable and patients undergoing surgery after failure of high dose radiation should be managed with extra precaution, but should not be excluded from the indications for SCPL.
Eur Arch Otorhinolaryngol (2011) 268:273–279, Received: 1 July 2010 / Accepted: 23 July 2010 / Published online: 10 August 2010 Springer-Verlag 2010
