Impairment of wound healing after operative treatment of mandibular fractures, and the influence of dexamethasone

Abstract Our aim was to clarify the incidence of impaired wound healing after open reduction and ostheosynthesis of mandibular fractures, and to find out whether the use of dexamethasone during the operation increased the risk. Patients were drawn from a larger group of healthy adult dentate patient...

Full description

Saved in:
Bibliographic Details
Published in:British journal of oral & maxillofacial surgery 2013-12, Vol.51 (8), p.808-812
Main Authors: Snäll, Johanna, Kormi, Eeva, Lindqvist, Christian, Suominen, Anna Liisa, Mesimäki, Karri, Törnwall, Jyrki, Thorén, Hanna
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age Factors
Anti-Inflammatory Agents - therapeutic use
Bone Plates
Bone Screws
Dentistry
Dexamethasone
Dexamethasone - therapeutic use
Female
Follow-Up Studies
Fracture
Fracture Fixation, Internal - instrumentation
Fracture Fixation, Internal - methods
Fracture Healing - drug effects
Glucocorticoid
Glucocorticoids - therapeutic use
Healing
Humans
Male
Mandibular
Mandibular Fractures - drug therapy
Mandibular Fractures - surgery
Middle Aged
Operative Time
Premedication
Risk Factors
Sex Factors
Single-Blind Method
Smoking
Surgery
Surgical Wound Infection - etiology
Treatment Outcome
Wound
Wound Healing - drug effects
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Our aim was to clarify the incidence of impaired wound healing after open reduction and ostheosynthesis of mandibular fractures, and to find out whether the use of dexamethasone during the operation increased the risk. Patients were drawn from a larger group of healthy adult dentate patients who had participated in a single-blind, randomised study, the aim of which was to clarify the benefits of operative dexamethasone after treatment of facial fractures. The present analysis comprised 41 patients who had had open reduction and fixation of mandibular fractures with titanium miniplates and monocortical screws through one or 2 intraoral approaches. The outcome variable was impaired healing of the wound. The primary predictive variable was the perioperative use of dexamethasone; other potential predictive variables were age, sex, smoking habit, type of fracture, delay in treatment, and duration of operation. Wound healing was impaired in 13/41 patients (32%) (13/53 of all fractures). The incidence among patients who were given dexamethasone and those who were not did not differ significantly. Only age over 25 was significantly associated with delayed healing ( p = 0.02). The use of dexamethasone 30 mg perioperatively did not significantly increase the risk of impaired wound healing in healthy patients with clinically uninfected mandibular fractures fixed with titanium miniplates through an intraoral approach. Older age is a significant predictor of impaired healing, which emphasises the importance of thorough anti-infective care in these patients during and after the operation.
ISSN:0266-4356
1532-1940
DOI:10.1016/j.bjoms.2013.08.015