Surgical site infections after pediatric open airway reconstruction-A National Surgical Quality Improvement Program-Pediatric analysis.

Objectives: To determine the rate of surgical site infections (SSI) after pediatric open airway reconstruction using a nationwide database.
Study Design: Cross-sectional study of the American College of Surgeons National Surgical Quality Improvement Program-Pediatric (ACS NSQIP-P) Database.
Methods: The ACS NSQIP-P was queried for open airway surgeries between 2013 and 2019 determining postoperative SSI and wound dehiscence with a random sample of non-airway cases serving as a control group.
Results: A total of 637 laryngotracheoplasties (LTP), 411 tracheal resections (TR) and 2100 control procedures were included. LTP and TR were both performed on younger children with more comorbidities than control surgeries ( p  < .05). Postoperative wound complications occurred more often after airway reconstructions than non-airway cases (6.4% vs. 2.9%, p  < .001). Compared to non-airway procedures, LTP (OR: 2.42, 95% CI: 1.62-3.61) and TR (OR: 2.07, 95% CI: 1.28-3.66) developed increased SSI. Multiple logistic regression identified dirty or infected wounds (OR: 4.61, p  < .001, 95% CI: 2.35-9.03) and American Society of Anesthesiologists (ASA) Class IV (OR: 3.19, p  = .02, 95% CI: 1.12-8.39) as the strongest predictors of SSI after airway reconstruction.
Conclusions: SSI after pediatric airway reconstruction occur in 6% of cases and are increased in infected wounds and ASA Class IV surgeries. Recognizing common factors for these complications provide reliable benchmarking to design surgical quality improvement initiatives.
Level of Evidence: 4.
Competing Interests: Dr. Johnson is the editor of Laryngoscope Investigative Otolaryngology. He was not involved in the editorial evaluation of or decision to accept this article for publication.
(© 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)