title: The value of early intraoral incisions in patients with perimandibular odontogenic maxillofacial abscesses.
abstract: Perimandibular abscesses require drainage and removal of the underlying cause of infection. Traditionally drainage was established extraorally, but this can be associated with delay to treatment, because this is done under general anaesthesia. Between July 2008 and June 2013, 205 patients were initially either treated by immediate intraoral incision under local anaesthesia or extraoral incisions under general anaesthesia and prospectively evaluated. Predictors of treatment outcomes and complications were analysed. Fewer secondary procedures were needed for patients with primary treatment under general anaesthesia (p < 0.0001), but the overall stay in hospital was shorter after initial treatment under local anaesthesia (p < 0.0001, Odds Ratio (OR) 0.72, 95% CI 0.62-0.85). Postoperative complications occurred significantly more often under general anaesthesia (p < 0.0001, OR = 16.63, 95% CI 5.59-49.5). Significant prognostic variable was the administration of amoxicillin combined with clavulanic acid (p = 0.016, OR = 1.24, 95% CI 1.09-1.41) and adverse prognostic factors were infections with Human Immunodeficiency Virus (HIV) (p = 0.048, OR 17.45, 95% CI 1.02-298) or diabetes mellitus (p = 0.003, OR 10.39, 95% CI 2.23-48.41). Amoxicillin combined with clavulanic acid showed a significant impact on the treatment course of patients with perimandibular abscesses.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany. Electronic address: th.mucke@gmx.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Nina
authors.initials: N
authors.lastname: Dujka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Ermer
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Klaus-Dietrich
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Kesting
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: David A
authors.initials: DA
authors.lastname: Mitchell
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Lucas
authors.initials: L
authors.lastname: Ritschl
authors.affiliation: Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum Rechts der Isar, Ismaninger Str. 22, 81675 München, Germany.
authors.forename: Herbert
authors.initials: H
authors.lastname: Deppe
mesh_terms: D000038:Abscess / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000768:Anesthesia, General / Q000379:methods; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D048909:Diabetes Complications; D004322:Drainage / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007902:Length of Stay; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods; D011183:Postoperative Complications; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D055815:Young Adult; D065093:beta-Lactamase Inhibitors / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D065093:beta-Lactamase Inhibitors; D019980:Amoxicillin-Potassium Clavulanate Combination
keywords: Abscess incision; Antibiotics; Outcome; Prospective study