Case of late‐onset, relapsing surgical site infection related to a venous coupler placed during free flap reconstruction for major head and neck cancer

Case of late‐onset, relapsing surgical site infection related to a venous coupler placed during... INTRODUCTIONDevices for microvascular anastomosis have been available for several decades and their use in major head and neck surgery has increased rapidly in recent years. Reported complications are usually related to the risk of anastomotic failure or vessel thrombosis. To our knowledge, infectious complications relating to venous couplers have not previously been described in the head and neck cancer population.Surgical site infections after surgery for head and neck cancer are defined by the Centers for Disease Control and Prevention as infections occurring within 30 days postoperatively. Late‐onset (>30 days) wound breakdown from infection is rare, and usually occurs only in the setting of osteoradionecrosis or recurrent cancer. We present a case of late‐onset neck abscess developing at the surgical site 7 weeks postoperatively in the setting of chemoradiation, with subsequent healing but 2 relapses despite completing radiation. There was no evidence of recurrent cancer or osteoradionecrosis, and removal of a venous coupler led to infection resolution without relapse.CASE REPORTA 79‐year‐old woman with a history of squamous cell carcinoma of the left lateral tongue treated with partial glossectomy 8 years earlier presented with recurrent cancer in the same location. She underwent near total glossectomy, left modified radical neck dissection, tracheotomy, http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Head & Neck: Journal for the Sciences & Specialties of the Head and Neck Wiley

Case of late‐onset, relapsing surgical site infection related to a venous coupler placed during free flap reconstruction for major head and neck cancer

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
1043-3074
eISSN
1097-0347
D.O.I.
10.1002/hed.25043
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONDevices for microvascular anastomosis have been available for several decades and their use in major head and neck surgery has increased rapidly in recent years. Reported complications are usually related to the risk of anastomotic failure or vessel thrombosis. To our knowledge, infectious complications relating to venous couplers have not previously been described in the head and neck cancer population.Surgical site infections after surgery for head and neck cancer are defined by the Centers for Disease Control and Prevention as infections occurring within 30 days postoperatively. Late‐onset (>30 days) wound breakdown from infection is rare, and usually occurs only in the setting of osteoradionecrosis or recurrent cancer. We present a case of late‐onset neck abscess developing at the surgical site 7 weeks postoperatively in the setting of chemoradiation, with subsequent healing but 2 relapses despite completing radiation. There was no evidence of recurrent cancer or osteoradionecrosis, and removal of a venous coupler led to infection resolution without relapse.CASE REPORTA 79‐year‐old woman with a history of squamous cell carcinoma of the left lateral tongue treated with partial glossectomy 8 years earlier presented with recurrent cancer in the same location. She underwent near total glossectomy, left modified radical neck dissection, tracheotomy,

Journal

Head & Neck: Journal for the Sciences & Specialties of the Head and NeckWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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