title: Postoperative infections in craniofacial reconstructive procedures.
abstract: The rate of, and possible risk factors for, postoperative craniofacial infection is unclear. To investigate this problem, we reviewed 349 cases of craniofacial skeletal procedures performed from 1996 to 1999 at our institution. Infection rate was determined and correlated with the use of implants, operative site, and cause of deformity. The inclusion criteria consisted of all procedures requiring autologous or prosthetic implantation in craniofacial skeletal sites, as well as all procedures involving bone or cartilage resection, osteotomies, debridement, reduction and/or fixation. Procedures that did not involve bone or cartilage surgery were excluded. The criteria for diagnosis of infection included clinical confirmation and one or more of 1) intravenous or oral antibiotic treatment outside of the prophylactic surgical regimen; 2) surgical intervention for drainage, irrigation, and or debridement; and 3) microbiological confirmation. Among the 280 surgical cases that fit the inclusion criteria and had complete records, there were 23 cases of postoperative infection (8.2%). The most common site for postoperative infection was the mandible (infection rate = 16.7%). Multiple logistic regression analysis revealed gunshot wound to be the most significant predictor of postoperative infection. Additionally, porous polyethylene implantation through a transoral route was correlated with a significant risk of postoperative infection.
authors.affiliation: Division of Plastic Surgery, Sunnybrook and Women's College Health Science Center, University of Toronto, Ontario, Canada. Jeff.Fialkov@swchsc.on.ca
authors.forename: J A
authors.initials: JA
authors.lastname: Fialkov
authors.forename: C
authors.initials: C
authors.lastname: Holy
authors.forename: C R
authors.initials: CR
authors.lastname: Forrest
authors.forename: J H
authors.initials: JH
authors.lastname: Phillips
authors.forename: O M
authors.initials: OM
authors.lastname: Antonyshyn
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D006259:Craniocerebral Trauma / Q000601:surgery; D019465:Craniofacial Abnormalities / Q000601:surgery; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D016015:Logistic Models; D008297:Male; D008446:Maxillofacial Injuries / Q000601:surgery; D009864:Ontario / Q000453:epidemiology; D011095:Polyethylenes / Q000009:adverse effects; D016459:Prosthesis-Related Infections / Q000453:epidemiology* / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D014948:Wounds, Gunshot / Q000601:surgery
chemical_list: D011095:Polyethylenes