OBJECTIVES This study was designed to assess the influence of peri/post-operative antibiotic prophylaxis (POABP) and the reconstructive graft itself on recipient sites infections in head and neck surgery. MATERIALS AND METHODS In this retrospective cohort study, 322 consecutive patients with reconstructive surgery were investigated. The primary objective was to analyze the differences of commonly applied reconstructive grafts on the occurrence of oral recipient site infections. Moreover, differences of POABP regimes (namely: ampicillin/sulbactam, 2nd generation cephalosporins, clindamycin) and antibiotic alternatives were investigated. In addition, patients' length of in-hospital stay was analyzed in regard to reconstructive graft and POABP regime. RESULTS The free radial forearm flap and split-thickness skin graft presented significantly less recipient site infections and shorter length of in-hospital stays (LOS) in comparison to further six reconstructive technique with pedicled tissue transfer or bone transfers. LOS was significantly shorter for patients with ampicillin/sulbactam than with 2nd generation cephalosporins as POABP. 91% of the harvested pathogens (n=193) were susceptible to the combination of 2nd and 3rd generation cephalosporins. Secondly, 92 out 113 (81%) harvested pathogens presented susceptibility to moxifloxacin. CONCLUSION Smaller tissue transfers are less prone to infections of the recipient site and present low LOS. For an POABP regime, the combination of 2nd and 3rd generation cephalosporins presents substantial results in recipient site infections. In cases of allergy, potential pathogens show adequate susceptibility to moxifloxacin. CLINICAL RELEVANCE A combination of 2nd and 3rd generation cephalosporins may be used to prevent recipient sites in head and neck surgery.

中文翻译：

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重建手术中的口腔受体部位感染-移植物本身和围手术期抗生素的影响。

目的本研究旨在评估围手术期/术后抗生素预防（POABP）和重建性移植物本身对头部和颈部手术中受体部位感染的影响。材料与方法在这项回顾性队列研究中，对322例连续性手术患者进行了研究。主要目的是分析常见的重建移植物在口腔受体部位感染发生方面的差异。此外，还研究了POABP方案的差异（即：氨苄青霉素/舒巴坦，第二代头孢菌素，克林霉素）和抗生素替代方案。此外，就移植重建和POABP方案对患者的住院时间进行了分析。结果与采用带蒂组织转移或骨转移的另外六种重建技术相比，自由的radial骨前臂皮瓣和厚薄的皮肤移植物显着减少了受体部位感染，缩短了住院时间（LOS）。氨苄西林/舒巴坦患者的LOS明显短于第二代头孢菌素作为POABP的患者。91％的病原体（n = 193）对第二代和第三代头孢菌素的组合敏感。其次，在113种（81％）收获的病原体中，有92种表现出对莫西沙星的敏感性。结论较小的组织转移不易感染受体部位，并且LOS低。对于POABP方案，第2代和第3代头孢菌素的组合在受体部位感染中表现出实质性的结果。在过敏的情况下，潜在的病原体对莫西沙星表现出足够的敏感性。临床相关性第2代和第3代头孢菌素的组合可用于预防头部和颈部手术中的受体部位。