Original Article

The prophylactic use of antibiotics in submandibular gland excision: an audit and review of risk factors

Anne Louise Tescher, Nazanin Ahmadi, Bing Mei Teh


Background: Submandibular gland excision is a common procedure in head and neck surgery. The current evidence-based guideline does not support the routine use of antibiotic prophylaxis for this procedure.
Methods: A retrospective review of all patients who underwent submandibular gland excision over a 9-year period (2010 to 2018) at a tertiary Victorian hospital was conducted. Data relating to demographic, comorbidities, antibiotic use and surgical complications was collected. The aim was to identify key indicators associated with the development of wound related complications in the presence or absence of antibiotic prophylaxis.
Results: Fifty-four patients met the selection criteria. Forty-seven (87.0%) received prophylactic antibiotic therapy. Complications reviewed were wound related complications, including seroma, haematoma, and wound infection. Nine (16.7%) patients developed one of these complications. Seven (13.0%) patients received antibiotics and developed a complication. Two (3.7%) patients developed a complication and did not receive antibiotics.
Conclusions: Our data demonstrates that there is variation in practice with regards to antibiotic prophylaxis. A majority of patients received prophylactic antibiotics. The introduction of new guidelines has not drastically changed surgeons’ attitude. Compliance with the guideline was inconsistent, with a trend of decreasing antibiotic use in the last two years. Infection rates were in keeping with the literature. No specific risk factors were identified to be associated with surgical complications, in the presence or absence of antibiotic prophylaxis.

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