It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients.
A nested case–control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI).
There were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p < 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04–3.18) and lymph node dissection, OR 3.22 (95% CI 1.32–7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients.
Lymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.
Urban JA (2006) Cost analysis of surgical site infections. Surg Infect (Larchmt) 7(Suppl 1):S19–S22 CrossRef
Leem TH, Volpi E, Eisele DW (2003) Non-neural complications of thyroid and parathyroid surgery. In: Randolph GW (ed) W. B. Saunders, Philadelphia
Karayacin K, Besim H, Ercan F et al (1997) Thyroidectomy with and without drains. East Afr Med J 74:431–432 PubMed
Gentile I, Rosato L, Avenia N et al (2014) Do Italian surgeons use antibiotic prophylaxis in thyroid surgery? Results from a national study (UEC-Italian Endocrine Surgery Units Association). Ann Ital Chir 85:33–37 PubMed
Tian J, Li L, Liu P et al (2016) Comparison of drain versus no-drain thyroidectomy: a meta-analysis. Eur Arch, Otorhinolaryngol
Schoretsanitis G, Melissas J, Sanidas E et al (1998) Does draining the neck affect morbidity following thyroid surgery? Am Surg 64:778–780 PubMed
Annual Report (2015) Scandinavian quality register for thyroid, parathyroid and adrenal surgery
- A Nested Case–Control Study on the Risk of Surgical Site Infection After Thyroid Surgery
F. A. Salem
C. I. Lundgren
- Springer International Publishing
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