Incidence of surgical site infection in head and neck surgery: a prospective cohort study

Objectives: Surgical site infection (SSI) causes high morbidity. Our aim was to study the incidence of SSI and to assess its risk factors in patients undergoing head and neck surgery. Methods: A prospective cohort study was conducted, from July 2007 to June 2023, by collecting data on patient, surgery, and infection-related variables, and calculating the incidence of SSI after a maximum follow-up period of 1 year. We assessed the effect of the different risk factors on SSI, using the relative risk adjusted with a logistic regression model. Results: We included 423 patients, mean age 65.8 years (standard deviation: 12.4). The most frequent comorbidities were neoplasms (82.1%) and diabetes mellitus (29.3%). The cumulative incidence of surgical infection across the follow-up period was 6.4% (95% confidence interval: 4.1-8.7). Most infections were superficial, with the most common microorganism being Enterobacter cloacae (42.8%). Duration of surgery above the 75^th percentile was the only risk factor associated with SSI in the multivariate analysis (p = 0.01). Conclusions: The incidence of infection was low in neck surgery. Infection rates must be assessed continuously, and SSI risk factors identified early through the implementation of prospective hospital surgical-infection surveillance and control programs.