O60: SURGICAL SITE INFECTION AND ANTIMICROBIAL RESISTANCE FOLLOWING RESECTION AND RECONSTRUCTIVE SURGERY FOR ORAL CANCERS: ARE WE READY FOR THE SUPER BUGS?

Surgical site infection(SSI) is the most common complication occurring in 19 to 47% of patients undergoing surgery for oral cancers. This study aims to assess the predictive factors of SSIs and antibiotic resistance patterns in patients undergoing surgery for oral cancers. Method The Clinico-pathological data of all patients who underwent surgery for oral cancers at our centre between October 2014 and May 2019 were reviewed. The differences between groups were compared by using independent samples t-test or Mann-Whitney U test and categorical data were analysed by Pearson's chi-square test, Fisher's exact or continuity correction. ROC curve was plotted to find the cut-off levels for the various predictors of SSI, using the Youden's index method. A linear regression analysis was done to define the cause-effect relationship of categorical response variables with explanatory variables. Result Of the 135 patients in our cohort, 43 patients(31.2%) developed SSI.Univariate and multivariate analysis showed that Diabetes, BMI>25 or <18, Neutrophil-to-Lymphocyte Ratio(NLR)>3.75, Platelet-to-Lymphocyte Ratio(PLR)>137.5, neo-adjuvant chemotherapy or radiotherapy, prolonged operative duration and prolonged anaesthesia exposure may render patients more vulnerable to SSI. On regression analysis, a PLR>137.5, NLR>3.75 and BMI>25 or <18 were found to be highly predictive of SSI. The highly resistant organisms isolated were staphylococcus aureus and enterococcus species. Conclusion The identification of these risk factors in patients undergoing surgery for oral cancers can help in identification of patients who may be at a higher risk of developing SSI and therefore help in improving the overall outcome, especially in an LMIC setting. Take-home message Identification of risk factors for surgical site infections in patients could help in prompt management of SSI and can also help in reduction of overall morbidity. The awareness and prevention of antibiotic resistance is vital for good outcomes in reconstructive surgery.