Bacteriological assessment of patients undergoing major Head and Neck surgery

Abstract
The use of chemoprophylaxis in major head and neck surgery is controversial. Prior to conducting a prospective trial a controlled microbiological monitoring of 32 patients was performed to determine a suitable antibiotic for prophylaxis. Wound infection occurred in 22 (68%) patients with fistulae occurring in 10 of these patients (45.5%). Preoperative cultures were of limited value in predicting subsequent sepsis. Gram-negative aerobic bacilli were the commonest group of pathogens (34.4%) isolated postoperatively. From projected resistance profiles of pathogenic and opportunistic bacteria amoxycillin and clavulanic acid was chosen as a suitable antibiotic.