{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T02:44:59Z","timestamp":1783651499014,"version":"3.55.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,10,22]],"date-time":"2016-10-22T00:00:00Z","timestamp":1477094400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ann Otol Rhinol Laryngol"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate surgical site infections (SSI) after pedicled reconstruction in head and neck surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Records of patients with pedicled flap reconstructions between 2009 and 2014 at Massachusetts Eye and Ear were reviewed. Onset of SSI or fistula \u226430 days postoperatively was noted. A free flap cohort was reviewed for comparison.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Two hundred and eight pedicled reconstructions were performed for cancer (83%), osteoradionecrosis (7%), and other reasons (10%). Most (72%) cases were clean-contaminated and American Society of Anesthesiologists classification 3 or higher (73%); 63% of patients had prior radiation. The SSIs occurred in 9.1% and were associated with a longer length of stay ( P = .004) but no particular risk factors. Seventeen patients developed a fistula (11 without SSI). The SSI rates were not significantly different between pedicled and free flaps, but pedicled flap patients were older, more likely to have had prior surgery and\/or radiation, and be methicillin-resistant Staphylococcus aureus positive. In the combined population, multivariate analysis demonstrated clean-contaminated wound classification ( P = .03), longer operating time ( P = .03), and clindamycin prophylaxis ( P = .009) as SSI risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The SSI rate following pedicled flap surgeries was low and similar to free flap surgeries despite a significantly different population. No specific risk factors were associated with developing a pedicled flap SSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0003489416672871","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T20:29:53Z","timestamp":1476822593000},"page":"20-28","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":37,"title":["Surgical Site Infections in Major Head and Neck Surgeries Involving Pedicled Flap Reconstruction"],"prefix":"10.1177","volume":"126","author":[{"given":"Neerav","family":"Goyal","sequence":"first","affiliation":[{"name":"Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA"},{"name":"Department of Surgery, Division of Otolaryngology Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bharat B.","family":"Yarlagadda","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA"},{"name":"Lahey Hospital & Medical Center, Department of Otolaryngology, Burlington, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel G.","family":"Deschler","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin S.","family":"Emerick","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick T.","family":"Lin","sequence":"additional","affiliation":[{"name":"Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie L.","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Nursing, Massachusetts Eye and Ear, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Rocco","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene L.","family":"Durand","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Department of Medicine, Infectious Disease Unit, and Massachusetts Eye and Ear, Infectious Disease Service, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,10,22]]},"reference":[{"key":"bibr1-0003489416672871","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2008.10.015"},{"key":"bibr2-0003489416672871","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199905000-00022"},{"key":"bibr3-0003489416672871","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-010-0468-4"},{"key":"bibr4-0003489416672871","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24005"},{"key":"bibr5-0003489416672871","unstructured":"American Society of Anesthesiologists. ASA Physical Status Classification System. http:\/\/www.asahq.org\/resources\/clinical-information\/asa-physical-status-classification-system. Accessed July 1, 2015."},{"key":"bibr6-0003489416672871","unstructured":"Surgical Site Infection (SSI) event. http:\/\/www.cdc.gov\/nhsn\/PDFs\/pscManual\/9pscSSIcurrent.pdf. 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