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  • Title: Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck.
    Author: Carroll WR, Rosenstiel D, Fix JR, de la Torre J, Solomon JS, Brodish B, Rosenthal EL, Heinz T, Niwas S, Peters GE.
    Journal: Arch Otolaryngol Head Neck Surg; 2003 Jul; 129(7):771-4. PubMed ID: 12874080.
    Abstract:
    BACKGROUND: Twenty-four hours of perioperative antibiotics provides effective prophylaxis for most head and neck cancer resections. Many reconstructive surgeons have been hesitant to apply this standard to free-flap reconstruction of the head and neck. This prospective clinical trial compared short-course and long-course clindamycin prophylaxis for wound infection in patients with head and neck cancer undergoing free-flap reconstruction. METHODS: Seventy-four patients were randomized to receive short-course (3 doses) or long-course (15 doses) clindamycin perioperatively. Wound infections, fistulas, and other postoperative complications were documented by faculty surgeons who were blinded as to treatment group. RESULTS: The differences in wound infections and other complications were statistically insignificant. No other independent predictors of wound complications emerged in this series of patients. CONCLUSIONS: Short-course clindamycin is as effective as long-course clindamycin in preventing wound infections after free-flap surgery for head and neck ablative defects.
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