Prevalence of Surgical Site Infections Following Orthognathic Surgery: A Double-Blind, Randomized Controlled Trial on a 3-Day Versus 1-Day Postoperative Antibiotic Regimen

Davis, Clayton M.; Gregoire, Curtis; Davis, Ian D.; Steeves, Thomas W.

doi:10.1016/j.joms.2016.09.038

Cited by 36 publications

(47 citation statements)

References 12 publications

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“…Design of CAD/CAM implants may be a compromise between susceptibility to bacterial infection and biocompatibility, and to date very few clinical data exist on this. Infection rates in the mandible are generally higher than in the maxilla (Davis et al, 2017). Wound problems were also surprisingly common in both of our study groups.…”

Section: Discussionmentioning

confidence: 43%

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — Up to 3-year follow-up

Suojanen

Järvinen

Hodzic

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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The use of individually designed osteotomies, combined with individually manufactured osteosynthesis material, is rapidly becoming a standard for more challenging maxillofacial surgery. The benefits of patient-specific implants (PSI) in orthognathic surgery are clear in complex cases. PSIs can enhance precision and ease up the surgical protocol. We previously reported on the benefits of PSIs as reposition and fixation systems during Le Fort I osteotomy. The aim of this study was to evaluate a cohort of 28 patients, treated with bilateral sagittal split osteotomy (BSSO) and PSIs for fixation, with regard to healing for up to 3 years. A retrospective cohort of 48 patients with conventional mini-plate repositioned mandibles was also collected for statistical analysis. No statistically significant differences were found with regard to infection, soft tissue problems, or reoperations between these two groups.

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Section: Discussionmentioning

confidence: 43%

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — Up to 3-year follow-up

Suojanen

Järvinen

Hodzic

et al. 2019

Journal of Cranio-Maxillofacial Surgery

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“…In both of our study groups, all patients were treated with a similar surgical protocol and perioperative intravenous antimicrobial therapy with either cefuroxime or ampicillin. The infection rates in the maxilla are in general low as compared to those in the mandible (Davis et al, 2017). Our study showed similarly low infection rates in both groups.…”

Section: Discussionsupporting

confidence: 57%

Comparison between patient specific implants and conventional mini-plates in Le Fort I osteotomy with regard to infections: No differences in up to 3-year follow-up

Suojanen

Järvinen

Kotaniemi

et al. 2018

Journal of Cranio-Maxillofacial Surgery

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Individually designed osteotomies and milled or printed patient-specific osteosynthesis materials are rapidly becoming a standard in maxillofacial reconstructive surgery. The benefits of using patient-specific implants (PSIs) in orthognathic surgery are especially clear in complex cases, and for this reason they are rapidly becoming common practice. We have earlier reported the benefits related to the use of PSIs as reposition and fixation system in Le Fort I osteotomy. The aim of this study was to compare complications associated with fixation with PSIs (31 patients) versus conventional mini-plates (37 patients) in Le Fort I osteotomy. No statistically significant differences in infection, reoperations or soft tissue problems were observed between the two systems used. Interestingly, three of the 37 patients in the mini-plate group underwent reoperation due to insufficient advancement or malocclusion, whereas none of the patients in the PSI group needed reoperation. In conclusion, PSIs are reliable for use in orthognathic surgery, with no signs of infection associated complications.

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“…Surgical site infections (SSI) following orthognathic surgery occurs in 1.4 to 33.4% of cases. They are a major concern for surgical teams 3 , 4 . Preventive and therapeutic management is not standardized.…”

Section: Introductionmentioning

confidence: 99%

Severity and long-term complications of surgical site infections after orthognathic surgery: a retrospective study

Cousin

Boulétreau

Giai

et al. 2020

Sci Rep

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Surgical site infections (SSI) occur in 1.4% to 33.4% of cases after orthognathic surgery. This type of complication is a major concern to surgical teams, but there is no consensus for the prevention and treatment of SSI in orthognathic surgery. The purpose of this descriptive study was to evaluate the severity and the consequences of postoperative infections. The charts of all the patients operated on by the orthognathic surgery team between January 2015 and July 2017 were collected. All types of orthognathic procedures (Le Fort I maxillary osteotomy, bilateral sagittal split mandibular osteotomy, and genioplasty) were screened, and patients diagnosed with SSI were included. Demographic data, timing and severity of the infection, as well as long-term complications were recorded. Five hundred and twelve patients were screened. Forty-one patients (8%) presenting with SSI were included. There were 18 men and 23 women. The site of the infection was mandibular for 38 patients (92.7%) and maxillary for 3 patients (7.3%). The average time between surgery and infection was 31.5 days. Twenty-four patients received isolated oral antibiotics for inflammatory cellulitic reaction (58.8%), 15 patients had a localized collection treated by incision and drainage under local anesthesia (36.6%), and 2 patients had an extensive collection requiring surgical drainage under general anesthesia (4.9%). Five patients (12.2%) needed hardware removal for plate loosening, and 2 patients (4.9%) developed chronic osteomyelitis. Infection following orthognathic surgery is easily treated most of the time with no long-term complications. In cases of patients with potential risk factors for severe infection, antibiotics may be given with curative intents.

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Prevalence of Surgical Site Infections Following Orthognathic Surgery: A Double-Blind, Randomized Controlled Trial on a 3-Day Versus 1-Day Postoperative Antibiotic Regimen

Cited by 36 publications

References 12 publications

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — Up to 3-year follow-up

No differences in infections between patient-specific implants and conventional mini-plates in mandibular bilateral sagittal split osteotomy — Up to 3-year follow-up

Comparison between patient specific implants and conventional mini-plates in Le Fort I osteotomy with regard to infections: No differences in up to 3-year follow-up

Severity and long-term complications of surgical site infections after orthognathic surgery: a retrospective study

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