A randomized controlled trial on cross-infection control in maxillofacial trauma surgery: a comparison of intermaxillary fixation techniques.

Glove perforations and percutaneous injuries occur commonly during the treatment of facial fractures and reveal the need for safer techniques, especially in intermaxillary fixation. The Rapid IMF device does not use any wires and may provide better cross-infection control than wiring methods. The aim of this study was to test the hypothesis that Rapid IMF is associated with fewer glove perforations/ percutaneous injuries than traditional wiring techniques. The authors carried out a randomized controlled trial which included 120 patients with fractures of the mandible requiring open reduction and fixation. The participants were allocated either to the study group and treated with intraoperative Rapid IMF or to the control group and managed with intraoperative eyelet wire ties. Analysis of the results showed that the Rapid IMF group had significantly fewer glove perforations than the traditional method (0.67 per operation compared with 1.5), (P<0.0001). The incidence of skin-penetrating injuries was the same in both groups (rate 0.02/ procedure). The application of Rapid IMF was significantly faster than wiring (P<0.0001). Minor intraoperative complications were noted in both groups, but more in the Rapid IMF group. Most concerned loosening or fracture of the anchorage ties but the surgical outcome was not affected. Rapid IMF is a safer alternative to wiring methods with significant reduction in glove perforation rates and is quicker to apply than conventional wiring techniques.