Comparative study of two cefazolin prophylactic protocols in oncologic surgery of the larynx: A randomized trial.

OBJECTIVE: Patients who need major head and neck surgery like laryngectomy are at risk of postoperative wound infection. Although the role of antibiotics in prophylaxis of clean contaminated head and neck surgery has been well documented, controversy exists in the optimal antibiotic regimen.

METHODS: In two tertiary referral hospitals (Imam Khomeini and Amir Alam hospital), 90 patients undergoing laryngectomy were prospectively randomized into two groups receiving cefazolin perioperative prophylaxis either for 2 days or for 5 days from June 2004 to March 2006. Then patients were blindly examined for the development of wound infection.

RESULTS: No wound infection was detected in either group. Two (4.4%) mucocutaneous fistula occurred in the 2-day group, and 3 (6.7%) in the 5-day group. There was no statistically significant difference in the infection rate between two groups.

CONCLUSION: We conclude that a 2-day perioperative cefazolin prophylaxis is equally effective as longer therapies. The increased morbidity and cost of the latter are in favor of the 2-day prophylactic regimen.