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Determination of contamination of operation field in head and neck oncological surgery

Determination of contamination of operation field in head and neck oncological surgery. 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. Authors : Maciej Mazurek

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Determination of contamination of operation field in head and neck oncological surgery

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  1. Determination of contamination of operation field in head and neck oncological surgery 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. Authors: Maciej Mazurek Filip Nowakowski Artur Włodarczyk Michał Głuski Students' Scientific Group attached to Head andNeck 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: 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. Improve treatment Define possible complications Determinate contaminating factor

  4. Materials and Methods • The prospective study, which was approved by Bioethical Committee; • The study was performed during long time surgical resections with one-stage reconstruction; • Swabsweretakenfromsurgical field and surgicaldrapesevery 2 hours(at 0h, 2h, 4h, 6h); • Samplesweredelivered to thelaboratoryimmediately; • To analizeourresults we haveusedStatistica.

  5. Materials and Methods Culturing methods and microbial diagnostics: Microbialculturingmethods: • Blood agar plate– preliminaryculturing (24-48 h, 37 DegreesCentigrade, CO2 enhancedatmosphereifneeded); • CPS agar, Chapman agar – differentialculturing (24h, 37 DegreesCentigrade); Finalidentification and antibiogram: • ATB, • API, • VITEK

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

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

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

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

  10. Results: antibiogram

  11. Results: complications 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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