4 factors causing infection in laryngeal cancer surgery

Laryngeal cancer surgery is a contaminated surgery. The wound is connected to the pharynx and trachea. The secretions from the pharynx and trachea will continuously flow into the wound. Wound infection is sometimes inevitable. The following are the four common causes of infection.

1. Bacterial infection

Wound infection is caused by endogenous factors. At the end of surgery, those with positive wound culture may be infected. The number of bacteria causing wound infection must be above 105 per gram of tissue; in oropharyngeal secretions, the number of bacteria can reach 108-9/ml. The ratio of anaerobic bacteria to aerobic bacteria is 3:1-10:1, and they are mostly found in the tongue, gingival space and dental plaque.

2. Foreign matter

This may be related to the ligature in the wound and the use of thick silk thread to suture the cricohyoid anastomosis. The long-term retention of silk thread foreign matter and bacterial contamination became the reason for the long-term non-healing of the wound. When the silk thread was removed from the wound, the wound healed within a few days.

3. Preoperative radiotherapy

The local tissues that are radiotherapyed will produce occlusive vasculitis, which will cause local blood supply obstruction and reduce the tissue regeneration and repair capacity. When there are foreign bodies and bacterial infections, delayed wound healing or delayed infection are more likely to occur.

4. Type of surgery

The greater the surgical trauma, the greater the chance of wound contamination. Total laryngectomy plus cleaning has a long wound exposure time, a large resection range, and a high postoperative infection rate. The infection rate after total laryngectomy is about 25.9%, the infection rate after total laryngectomy plus cleaning is 39.6%, and the infection rates after vocal cord resection and vertical hemi-laryngectomy are 0.98% and 1.47%, respectively.