A single-center retrospective review of postoperative infectious complications in the surgical management of mandibular fractures

Abstract

Therapeutic study, level IV.

Postoperative prophylactic antibiotics for facial fractures: A systematic review and meta‐analysis

“…Similarly, among the four studies that compared postoperative versus perioperative antibiotic prophylaxis, there was no significant difference in the incidence of SSIs (RR = 1.22 [95% CI: 0.72‐2.07], P > .1). This finding also held true for the nine studies that compared postoperative versus pre‐ + perioperative antibiotic prophylaxis (RR = 1.08 [95% CI: 0.80‐1.45], P > .1). There was no significant or meaningful heterogeneity for any of these analyses ( I 2 = 0%, P > .1).…”

“…Studies ranged in size from 30 patients to 510, with RCTs generally including fewer patients than cohort studies . Furthermore, six studies only included patients undergoing open reduction, whereas the other seven included a mixture of open and closed reduction . The average age of patients was generally in the 30s to early 40s, except for two studies whose patients had an average age in the late 20s …”

“…The quality of cohort studies ranged from good, to moderate, to poor (Table ) . All included studies showed good ascertainment of the exposure.…”

“…Two of six cohort studies did not confirm the absence of the outcome at the start of the study, which may have overestimated the effect . Except for Domingo et al, there was no indication that medication compliance was accounted for in the analysis of the incidence of infection . In addition, four included studies (three RCTs and one cohort) were conducted within the same university medical centers by the same research group, which may impact generalizability .…”

“…Because several studies reported that prophylaxis was initiated from hospital admission through the perioperative period, but did not specify the length of time prior to surgery, we used an approach similar to Shridharani et al and considered this to be a combination of pre‐ and perioperative prophylaxis . Additionally, if studies explicitly stated that patients received preoperative antibiotic prophylaxis (in addition to perioperative antibiotics), they were placed in the pre‐ + perioperative group . We assumed that patients received only perioperative prophylaxis if studies referred to prophylaxis as perioperative or intraoperative .…”