[Infectious complications of mandibular osteotomy].
BACKGROUND
Infection is a rare complication after orthognathic surgery. A rate of 1% to 15% has been reported in the literature. We reviewed our experience.


METHODS
We reviewed retrospectively 60 mandibular osteotomies performed between 1998 and 1999. There were 41 women and 19 men, mean age 24 years. All were given antibiotic therapy using cefamandol 1500 mg preoperatively then 750 mg every 6 hours peroperatively and cefixime 400 mg/d postoperatively for 7 days. Patients were followed for at least 6 months after surgery.


RESULTS
There were 10 infections (16% of the cases) involving a hematoma in 2 cases, adenitis in 1, osteitis on a cortical fragment in 2 and osteitis on implanted material in 5.


CONCLUSIONS
We defined infection following orthognathic surgery as a collection or purulent fistula with either a high polynuclear count in the discharge fluid or a positive culture. Both soft tissue (for example infection of a perimandibular hematoma) or bone infections were equally considered. We found two types of risk factors: patient-related or procedure-related. Patient-related factors included smoking, paradontal status, and dental hygiene. The main procedure-related factor was duration of surgery. Measures of prevention include extraction of the wisdom teeth, interruption of smoking, preoperative scaling and careful dental care, rigorous operative technique, antibiotic therapy.
Cheynet
F
F
Service de Chirurgie Maxillo-Faciale et Stomatologie, Hôpital de la Timone, 13385 Marseille. fcheynet@mail.ap-hm.fr
Chossegros
C
C
Richard
O
O
Ferrara
J J
JJ
Blanc
J L
JL
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D001860:Bone Plates / Q000009:adverse effects; D002435:Cefamandole / Q000627:therapeutic use; D020682:Cefixime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D017577:Cutaneous Fistula / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000209:etiology; D006801:Humans; D008199:Lymphadenitis / Q000209:etiology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D009910:Oral Hygiene; D010000:Osteitis / Q000209:etiology; D010027:Osteotomy / Q000009:adverse effects*; D010510:Periodontal Diseases / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology* / Q000517:prevention & control; D013997:Time Factors
D002511:Cephalosporins; D002435:Cefamandole; D020682:Cefixime