title: The process of orthognathic care in an NHS region.
abstract: BACKGROUND
  The aim of this study was to evaluate, within an NHS region, the process of care and the standard of record keeping for orthognathic patients.
  
  
  METHODS
  A retrospective analysis of the medical records of 372 patients who underwent orthognathic surgery between 1 January 1995 and 31 April 2000 in the South West Region of the UK.
  
  
  RESULTS
  Most patients underwent joint orthodontic and maxillofacial planning and had third molars extracted under general anaesthesia prior to orthognathic surgery. There was a significant difference in the median operation times and length of stay for bimaxillary surgery (4 h/4 days) compared with single jaw surgery (2 h/3 days; P < 0.001). Just over 15% of patients required removal of internal fixation plates after surgery, with nearly 90% of these requiring a further episode of general anaesthesia. The level of record keeping and patient review was variable with no regional standardisation.
  
  
  CONCLUSIONS
  This study is evidence of a generally acceptable standard in the process of care, which was found to follow international and national practices. However, at the time of the study there was no regional protocol for patient records or patient review, highlighting the need for the establishment of a regional database.
authors.affiliation: Wimbledon Orthodontic Practice, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Parbatani
authors.forename: A C
authors.initials: AC
authors.lastname: Williams
authors.forename: A J
authors.initials: AJ
authors.lastname: Ireland
authors.forename: J R
authors.initials: JR
authors.lastname: Sandy
mesh_terms: D000293:Adolescent; D000328:Adult; D004739:England; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures / Q000379:methods*; D017064:Process Assessment, Health Care; D012189:Retrospective Studies; D013222:State Medicine; D055815:Young Adult