Presentations 2020: OMFS

388 - Extended use of antibiotics post-operatively in microvascular free-flap reconstructions in Oral and Maxillofacial Surgery.

S Jeffreys M Thomas L Mackie A Jenkinson M Kittur
Presented by: Sam Jeffreys
Morriston Hospital

Introduction Extended use of antibiotics in the perioperative period is commonly undertaken to reduce the potentially devastating effects of surgical site infection in head and neck reconstruction. Methods We performed a retrospective analysis of records of patients that underwent microvascular free-flap reconstruction between 11/2017 and 12/2018. Electronic documentation and patient notes were reviewed, collecting data on ASA, procedure length, intra-operative complications, antibiotic use and post-operative complications. Complications were then categories as medical or surgical. Results Initial search identified 34 eligible patients. 7 were subsequently excluded due to incomplete antibiotic data available. 27 patients, average age of 64 years (35 – 83.29) were included for full analysis. Flap donor sites were 17 (61%) Radial forearm, 9 (32%) Fibular and 2 (7%) Anterior Lateral Thigh. 1 patient required reconstruction with 2 free-flaps. Most patients received a varying length course of Ceftriaxone and Metronidazole, 13 (48.15%) received 5 days, 7 (25.93%) received 7 days, 6 (22.22%) received other durations ranging from 4 to 10 days and 1 patient received other combination of antibiotics. 26 (96.3%) patients received at least the minimum course as per the departmental protocol depending on type of free-flap used. Average length of stay was 21.8 days (6-175) with no significant difference between antibiotic groups. 13 (48.15%) of patients developed complications, 12 (44.4%) medical complications and 9 (33.3%) surgical complications. 6 (22.2%) developed both medical and surgical at some point while in-patients. There was no significant difference in complication rate between antibiotic groups. Conclusion We found no significant link between the development of post-operative complications, specifically antibiotic/hospital induced complications, in patients undergoing free-flap reconstruction when routinely treated with broad-spectrum antibiotics post-operatively.
Consent Statement: There are no details on individual patients reported within the abstract..

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