Post Operative Infection in Patients with ENT Cancer. A Report of 138 Cases

Moustapha Ndiaye, Ciré Ndiaye, Ngor Ndour, Malick Ndiaye, Abdou Sy, Mame Sanou Diouf, Amadou Thiam, Houra Ahmed, El Hadji Abdou Aziz Sylla, Birame Loum, Baye Karim Diallo, Louise Fortes Deguenonvo, Richard Deguenonvo, Evelyne Siga Diom, Abdourahmane Tall, Issa Cheikh Ndiaye, Raymond Diouf

Abstract



ABSTRACT
Background. Any surgical procedure involves an infectious risk due to the rupture of the barrier constituted by the skin or the mucous membranes. Through this study, we assessed the clinical, bacteriological and therapeutic profile of postoperative infections. Methods. This was a three year cross sectional retrospective study on a group of 138 patients with ENT cancer who had been extirpated. The circumstances of occurrence of post-operative infections were studied. Results. The frequency of post-operative infection was 23.9%. Among the 44 alcohol-smoking patients, 12 had a post-operative infection (p = 0.593). One patient had been treated with preoperative radiochemotherapy and dit not develop postoperative infection. The tumor size in the infected population corresponded to T2 (18.9%), T3 (22.5%), T4 (51.1%); p = 0.048 and the types of closure with flaps represented 17.9% (p = 0.001). Six class 1 Altemeier patients developed post-operative infection as well as 27 class 2; (p = 0.346). The incidence of infection in patients with a tracheostomy tube was 27.7%. The most common germs were Pseudomonas aeruginosa (16 cases), Enterobacter spp (4 cases), Staphylococcus aureus (3 cases). After consideration of the antibiogram, the most commonly used molecule was ciprofloxacin (21 cases). Conclusion. The occurrence of post-operative infection is strongly associated to the use of a closure flap, hence the need to observe strict hygiene for these patients who should benefit from it.

RÉSUMÉ
Introduction. Toute intervention chirurgicale comporte un risque infectieux du fait de la rupture de la barrière que constituent la peau ou les muqueuses. A travers cette étude, nous avons évalué le profil épidémiologique, bactériologique et thérapeutique des infections post opératoires. Patients et méthodes. Il s’agit d’une étude transversale rétrospective sur trois ans sur une série de 138 patients porteurs d’un cancer de la sphère ORL ayant été extirpé. Les circonstances de survenue des cas d’infections post opératoires ont été étudiées. Résultats. La fréquence de l’infection post opératoire était de 23,9%. Parmi les 44 patients alcoolo-tabagiques, 12 ont eu une infection post opératoire (p=0,593). Un patient ayant été traité par radio-chimiothérapie préopératoire n’a pas développé d’infection post opératoire. La taille de la tumeur dans la population infectée était celle correspondant aux classes T2 (18,9%), T3 (22,5%), T4 (51,1%); p=0,048 et les types de fermeture avec lambeaux représentaient 17,9 % (p=0,001). Six patients de classe 1 d’Altemeier ont développé une infection post opératoire ainsi que 27 de classe 2 ; (p=0,346). L’incidence de l’infection chez les malades porteurs d’une canule de trachéotomie était de 27,7%. Les germes les plus retrouvés avaient été le Pseudomonas aeruginosa (16 cas), Enterobacter spp (4 cas), Staphylococcus aureus (3 cas). Après l’adaptation à l’antibiogramme, la molécule la plus utilisée avait été la ciprofloxacine (21 cas). Conclusion. La survenue d’infection post opératoire a été fortement imputable à l’utilisation de lambeau de fermeture d’où la nécessité d’observer une hygiène stricte pour ces malades devant en bénéficier.

Keywords


infection, postoperative, operating site, ENT cancer, carcinology

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