Prevalence of postoperative complications after orthognathic surgery: a 15-year review.
OBJECTIVE
This study was conducted to determine the prevalence of postoperative complications after orthognathic surgery and evaluate the use of antibiotic prophylaxis in relation to the infection rate.


METHODS
All patients undergoing orthognathic procedures between 1990 and 2004 were studied retrospectively by retrieving their individual medical records. Demographic data, intraoperative data (specific orthognathic procedures and duration of operation), and postoperative data (type and duration of antibiotic prophylaxis and presence of postoperative complications) were recorded. Patients noted to have suffered any postoperative complications were studied in detail, and various factors, including gender, age, duration of operation, and use of prophylactic antibiotics, were analyzed using statistical tests in relation to postoperative infection.


RESULTS
A total of 2,910 orthognathic procedures were performed on 1,294 consecutive patients in the 15-year period, with 1,070 patients undergoing bimaxillary procedures and 224 patients undergoing single-jaw surgery. The orthognathic surgery-related complication rate was 9.7%, of which 7.4% was related to postoperative infection. Of the cases of infection, 58.3% were acute infection and 41.7% were chronic infection. Patients who received a single preoperative dose of antibiotics had a significantly higher infection rate (17.3%) than those who received postoperative antibiotics for various durations.


CONCLUSIONS
The prevalence of infection after orthognathic surgery was relatively low given the complexity of the procedures. No particular orthognathic procedure was more susceptible to infection. A preoperative dose of prophylactic antibiotics together with at least 2 days of postoperative doses was useful in reducing the infection rate compared with only a single dose of prophylactic antibiotics.
Chow
Lop Keung
LK
Discipline of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Hong Kong, Hong Kong.
Singh
Baldev
B
Chiu
Wai Kuen
WK
Samman
Nabil
N
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000601:surgery; D008334:Mandible / Q000601:surgery*; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000145:classification / Q000379:methods; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology* / Q000517:prevention & control; D015995:Prevalence; D012189:Retrospective Studies; D012737:Sex Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000517:prevention & control