口腔がん術後感染症とその予防

• Published in: 日本口腔外科学会雑誌 Vol. 62; no. 10; pp. 506 - 512
• Main Authors: 船原, まどか, 梅田, 正博, 林田, 咲, 五月女, さき子
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.10.2016
• Subjects: 口腔がん手術; 周術期口腔管理; 手術部位感染; 術後感染; 術後肺炎
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.62.506

We described postoperative infection after oral cancer surgery and its general prophylaxis, and showed our study about preventive effects of perioperative oral management on postoperative infection. The frequency of surgical site infection (SSI) after oral cancer surgery is high, especially in clean-contaminated surgery or major surgery. To prevent SSI, general prophylaxis recommended by CDC Guideline should be performed.　The number of oral bacteria increases remarkably in patients during intubation by trachectomy. We reported that topical administration of tetracycline ointment in the oral cavity reduced bacteria in the oropharyngeal fluid to the fewer level than that before intubation during 6 hours. A multicenter randomized clinical trial on the preventive effect of topical tetracycline administration on SSI is being performed now.　Postoperative pneumonia sometimes occurred in oral cancer surgery. The risk factors for development of postoperative pneumonia are old age, diabetes, lower pulmonary function, smoking, large surgical stress, postoperative dysphagia, etc. However, few investigators reported the relationship between oral hygiene and pneumonia. We reported that perioperative oral management reduced the risk of postoperative pneumonia in patients undergoing esophageal cancer surgery in a multicenter retrospective study. These results suggest that proper oral managements may prevent the development of postoperative pneumonia also in oral cancer surgery.