The Effect of Oral Health Care for the Prevention of Postoperative Infection on the Oral Cancer Reconstructive Surgery Cases

[Introduction] In late years the perioperative active oral health care makes intraoral number of bacteria decrease; it is proposed that decrease postoperative complications and aspiration pneumonitis, and intervention of the specialized oral health care spreads out. In particular, the prevention of postoperative complications in the high invasive surgery not only improves the quality of life of the patients, but also results in medical care economic effect by decreases of the hospitalization. Specialized oral health care in the perioperative period was introduced in earnest in this hospital from April, 2006 and it's provided for all surgery cases. In addition, we perform positively the eating function therapy in the surgery case with the eating dysfunction and endeavor to recover the oral cavity function early. Therefore we report this time that we tested usefulness of the oral health care for the perioperative period in the oral cancer reconstructive surgery case using the free flap with the vascular handle.[Subjects and Methods]We targeted at 28 oral cancer cases (the care group) whom we performed reconstructive surgery using a free flap with a vascular handle and a free bone flap from April, 2006 to March, 2010, and 25 oral cancer cases (the study group) before the care induction. We compared the body temperature change, the various test values including the white-cell count, presence or absence of wounded area infection, the postoperative antimicrobial agent administration days, the days until an oral intake, and investigated usefulness of the oral health care for the perioperative period. Regarding the evaluation of the infection of the wounded area, we made what drainage was detected from the wounded area "infection available" using the infection Grade classification in the head and neck surgery of Johnson et al. We conducted the examination by the chi-square test for monofactorial analysis, and the logistics analysis for multivariable analysis. We used the SPSS ver.13 for the the statistical analysis investigation and admitted significant difference with 0.05 or less of P value.[Results]The results is observed that wounded area was significantly little in the care group: two cases in care groups and seven cases, 31.8% in the 7.7% control group. Regarding other category, shortening of approximately nine days was observed in the days until the discharge in care group. After analyzing the factor about the postoperative infection, statistically significant difference was found in presence or absence of oral health care. In the logistics multivariable analysis, an odds ratio of 0.220 was demonstrated in presence or absence of oral health care, and the possibility was suggested that enforcement of the oral health care, the use of the wounded area covering material, an immunostimulation nutrient reduced the postoperative infection risk. [Conclusion]In oral cancer reconstructive surgery, it was suggested that statistically perioperative oral health care was one of the factors to promote the reduction of the risk of infection.