Evidence map›Paper›PMID 29083525›Full record

SynthesisHead & neck2018

Antibiotic prophylaxis in clean-contaminated head and neck cases with microvascular free flap reconstruction: A systematic review and meta-analysis.

Yarah M Haidar, Prem B Tripathi, Tjoson Tjoa, Sartaaj Walia, Lishi Zhang, Yanjun Chen, Danh V Nguyen, Hossein Mahboubi, William B Armstrong, Julie A Goddard

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Head & neck, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  10. Observational
  11. Surgical wound classification in otolaryngology: A state-of-the-art review.World journal of otorhinolaryngology - head and neck surgery · 2022
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Closing of large pharyngostomes with free flaps and proposal of a new classification.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2020
    Review
  18. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yarah M HaidarDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.ORCID 0000-0003-4211-6979
Prem B TripathiDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.
Tjoson TjoaDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.ORCID 0000-0001-8777-4145
Sartaaj WaliaDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.
Lishi ZhangInstitute for Clinical and Translational Science, University of California, Irvine, Irvine, California.
Yanjun ChenInstitute for Clinical and Translational Science, University of California, Irvine, Irvine, California.
Danh V NguyenDepartment of Medicine, University of California - Irvine School of Medicine, Irvine, California.
Hossein MahboubiDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.
William B ArmstrongDepartment of Otolaryngology - Head and Neck Surgery, University of California - Irvine, Irvine, California.
Julie A GoddardDepartment of Otolaryngology - Head and Neck Surgery, University of Colorado, Boulder, Colorado.

Funding

University of California Health Participation in the National COVID Cohort Collaborative (N3C)UL1TR001414 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI COOPER, DAN M, VILAIN, ERIC J. · 2015 to 2023
$35.1M
NCATS NIH HHS UL1 TR001414
6 · The paper itself

Abstract

backgroundOptimal antibiotic prophylaxis duration in head and neck clean-contaminated free-flap cases is unknown.

methodsA systematic review/meta-analysis was conducted using PubMed/MEDLINE, Cochrane Library, Web-of-Science, and Scopus databases.

resultsOf the 3755 searched articles, 5 articles were included for a total of 861 patients. The recipient surgical site infection risk was significantly higher in patients receiving prophylactic antibiotics for ≤24 hours compared to >24 hours (relative risk [RR] 1.56; 95% confidence interval [CI] 1.13-2.14). In the post hoc multivariate analysis based on available individual-level data on 697 patients from 3 studies, the risk of surgical site infection for ≤24 hours versus >24 hours was not significant after adjusting for antibiotic type (RR 1.09; 95% CI 0.78-1.55). When compared to ampicillin-sulbactam, patients who received clindamycin prophylaxis had an increased likelihood of recipient surgical site infection (RR 2.85; 95% CI 1.95-4.17).

conclusionLess than or equal to 24 hours of antibiotic prophylaxis in head and neck clean-contaminated free-flap is likely sufficient but a strong conclusion remains elusive. Clindamycin prophylaxis increases the risk of recipient surgical site infection. Further prospective trials are necessary to clarify.

Indexed as

Antibiotic ProphylaxisFree Tissue FlapsHead and Neck NeoplasmsHumansMicrovesselsSurgical Wound InfectionTime Factorsclean-contaminatedfree flapsmicrovascular surgeryprophylactic antibioticssurgical site infection

Identifiers

PMID29083525
PMCPMC6489503

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.