Reducing Surgical Site Infections in Oral Cancer Patients

Strategic Insights -

Research conducted at the Aichi Cancer Center has focused on finding effective ways to prevent surgical site infections (SSIs) in patients undergoing head and neck reconstruction for oral cancers. Despite numerous efforts to reduce SSI rates, they have remained high. A new perioperative wound management protocol has been introduced, which includes three steps: intraoperative irrigation of the surgical field with iodine saline, compression of the dead space in the postoperative period, and oral care by reconstructive surgeons. The protocol was implemented in 120 consecutive patients who underwent resection and free-flap reconstruction for oral cancers at the Aichi Cancer Center from 2020 to 2022.

Key Takeaways:

  • The Aichi Cancer Center introduced a new perioperative wound management protocol to reduce surgical site infections in patients undergoing head and neck reconstruction for oral cancers.
  • The protocol consisted of three steps: intraoperative irrigation of the surgical field with iodine saline, compression of the dead space in the postoperative period, and oral care by reconstructive surgeons.
  • A study including 120 consecutive patients who underwent resection and free-flap reconstruction for oral cancers compared the use of the protocol to traditional methods and found a significant reduction in SSI rates.
  • Statistical analysis found that perioperative wound management with the new protocol (P = 0.012, odds ratio [OR] = 0.350) and age (P = 0.024, OR = 0.963) were significantly associated with infection.
  • The protocol also resulted in a significant difference in the days nil by mouth (P = 0.014) and the length of hospitalization (P = 0.003) between the groups.
  • The study concluded that the perioperative protocol seemed to be effective in preventing postoperative SSIs, reducing the days of nil by mouth, and shortening hospital stay after oral cancer resection and reconstruction.
  • Authors of the study include Mikumo Nakakawaji, Ryota Nakamura, Aoi Oyama, Kosuke Mogi, Shunya Nabetani, Hiroto Uchikoshi, Seiko Okumura, Nobuhiro Hanai, and Keisuke Takanari from the Department of Plastic and Reconstructive Surgery, Aichi Cancer Center.

Statistics:

  • 120 consecutive patients underwent resection and free-flap reconstruction for oral cancers at the Aichi Cancer Center from 2020 to 2022.
  • 60 patients in the control group did not receive the perioperative wound management protocol, while 60 patients in the study group received the protocol.
  • SSI rates decreased significantly in the group that received the perioperative wound management protocol.
  • Patients who received the protocol had a shorter hospital stay (P = 0.003) and fewer days nil by mouth (P = 0.014).

Sources:

  • NewsRx. Aichi Cancer Center Researchers Focus on Oral Cancer (Strategies for Reducing Surgical Site Infections After Oral Cancer Resection and Free-flap Reconstruction). Cancer Weekly. October 21, 2025; p 198.
  • Strategies for Reducing Surgical Site Infections After Oral Cancer Resection and Free-flap Reconstruction. Plastic and Reconstructive Surgery, Global Open, 2025, 13(9):e7101. (Plastic and Reconstructive Surgery, Global Open - http://www.prsgo.com).