{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T10:00:20Z","timestamp":1780999220740,"version":"3.54.1"},"reference-count":48,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preirradiated patients undergoing microvascular head and neck reconstruction for tumor recurrence or osteoradionecrosis (ORN) face surgical site infection (SSI) rates exceeding 30%. The impact of perioperative extended\u2010spectrum antibiotic coverage remains unclear. This study hypothesizes that calculated prophylaxis with piperacillin\/tazobactam reduces early\u2010onset SSI in this high\u2010risk population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From a microvascular reconstructed cohort, 161 with prior irradiation were retrospectively identified (tumor,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009101; ORN,\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200960). SSI risk reduction was compared between patients receiving piperacillin\/tazobactam (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200939) and standard prophylaxis (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009122).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      With underlying SSI incidence of 36%, piperacillin\/tazobactam showed a fourfold SSI risk reduction (HR 0.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) across the entire cohort and a fivefold reduction in patients with bone resection (HR 0.17;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Subgroup analyses confirmed this effect with a sevenfold reduction in tumor patients (HR 0.14;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and a threefold reduction in ORN patients (HR 0.29;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Extended coverage did not significantly prolong antibiotic treatment times.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In summary, calculated use of piperacillin\/tazobactam in previously irradiated patients requiring microvascular reconstruction appears effective in reducing early\u2010onset SSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70151","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T05:30:16Z","timestamp":1767936616000},"page":"1519-1528","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative Piperacillin\/Tazobactam Reduces Early Onset\n                    <scp>SSI<\/scp>\n                    in Preirradiated Patients Undergoing Microvascular Head and Neck Reconstruction"],"prefix":"10.1002","volume":"48","author":[{"given":"Johannes G.","family":"Schuderer","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University Hospital Regensburg  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Hoferer","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University Hospital Regensburg  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Eichberger","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University Hospital Regensburg  Regensburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6822-3089","authenticated-orcid":false,"given":"Mathias","family":"Fiedler","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery University 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