Prevention and treatment of postsurgical head and neck infections

Postoperative wound infection is an important cause of postsurgical morbidity. Efforts to reduce the incidence of wound infection are enhanced through appropriate preoperative preparation, adherence to excellent surgical technique, and the provision of outstanding postoperative care. Many head and neck surgical procedures are undertaken in an environment contaminated by saliva containing a large inoculum of potentially pathogenic bacteria. Prospective randomized clinical trials have demonstrated that perioperative antibiotic prophylaxis reduces the risk for postoperative wound infection. Effective antibiotic prophylaxis requires that the antibiotic be effective against normal oral flora. Antibiotics should be administered before wound contamination. The dose of the antibiotic should exceed the minimal inhibitory concentration needed for the normal flora. The antibiotic administration can cease within 24 hours of surgery.