Antibioprophylaxis in Orthognathic Surgery: A Comparison of 2 Protocols
Postoperative infections in orthognathic surgery causes pain and discomfort to the patient, can interfere with normal bone healing and may require prolong antibiotic treatment and other surgical interventions. The current literature brings conflicting rates of infections due to the lack of standardized protocols and the small number of patients included in the studies. The purpose of this retrospective study is to assess the infection rates in orthognathic surgery.
MATERIALS AND METHODS :
The charts of 1652 patients who underwent orthognathic surgery were retrospectively reviewed. Clinical follow-ups were done at 1, 3 and 6 weeks post-surgery. An infection was diagnosed when at least one of the criteria of the Centers for Disease Control and Preventionwas noted: purulent discharge at the surgical site, presence of signs and symptoms, positive microbiology culture or clinical diagnosis of a surgeon. The following data were recorded: age, gender, date and type of procedure, clinical notes, follow-up periods, antibioprophylaxis protocol, presence of infection and its treatment
RESULTS
1652 patients, 1030 women and 622 men, were included in this study. 122 cases of infection were diagnosed (7.39%). The rate of infection for LeFort I was 2.02% (20/986), 5.72% for surgically assisted rapid palatal expansion (13/227), 6.88% for bilateral surgical split osteotomy and other mandibular osteotomies, (80/1162), and 1.79% for the genioplasty (9/502).
CONCLUSION
The infection rate observed in this study is slightly lower than the 10-15 % usually reported. An increased rate of infection was noted for the BSSO compared to other procedures.
CONFLICT OF INTEREST : None declared
REFERENCES
1- Danda AK, Wahab A, Narayanan V, Siddareddi A. Single-dose versus single-day antibiotic prophylaxis for orthognathic surgery: a prospective, randomized, double-blind clinical study. J Oral Maxillofac Surg. 2010 Feb;68(2):344-6.
2- Tan SK, Lo J, Zwahlen RA. Perioperative antibiotic prophylaxis in orthognathic surgery: A systematic review and meta-analysis of clinical trials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Dec 16.