Prajapati V K, Shahi Ajoy Kumar, Prakash Om
Department of Oral and Maxillofacial Surgery, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Ann Maxillofac Surg. 2020 Jul-Dec;10(2):330-334. doi: 10.4103/ams.ams_239_19. Epub 2020 Dec 23.
Open reduction and internal fixation (ORIF) can be complicated by miniplate exposure, loosening, or infection. Infected miniplates lead to exposure, extrusion, fistula formation, bony nonunion, and osteomyelitis. Whenever any posttreated cases of ORIF become infected, it is treated blindly with a high dose of antibiotics and surgical removal of infected miniplates or screws. The aim and objectives of the study were to identify the frequency and site of infection in craniomaxillofacial implants and significance of microbes isolated from the infected region.
Removal of miniplates was being performed on 19 patients. Among them, 14 had infection or sinus opening, 3 had plate exposure, and 2 were removed asymptomatically according to patient willingness. Aspirated fluid/pus was collected and sent for microbial culture and sensitivity test. Test of significance of individual microbes was done using -test and the value of was calculated.
Among 14 patients associated with miniplate infection, 11 (78%) had infection in the mandible and 3 at zygoma. The bacteria isolated were mainly (7) along with coagulase-negative (2), (3), (2), (2), and (1). was predominantly present in majority of the samples and statistically significant at = 0.023.
The present study observed that in contrast to other sites in the body, there is versatility in microbial flora in the craniomaxillofacial region. It is essential for routine microbial analysis of samples and antibiotic susceptibility test for proper treatment of such cases.
切开复位内固定术(ORIF)可能会并发微型钢板暴露、松动或感染。感染的微型钢板会导致暴露、挤出、瘘管形成、骨不连和骨髓炎。每当ORIF的任何术后病例发生感染时,都会盲目地使用高剂量抗生素治疗,并手术取出感染的微型钢板或螺钉。本研究的目的是确定颅颌面植入物感染的频率和部位,以及从感染区域分离出的微生物的意义。
对19例患者进行微型钢板取出术。其中,14例有感染或窦口开放,3例有钢板暴露,2例根据患者意愿无症状取出。收集吸出的液体/脓液并送去进行微生物培养和药敏试验。使用t检验对单个微生物进行显著性检验,并计算P值。
在14例与微型钢板感染相关的患者中,11例(78%)下颌骨感染,3例颧骨感染。分离出的细菌主要是金黄色葡萄球菌(7例),还有凝固酶阴性葡萄球菌(2例)、肺炎克雷伯菌(3例)、铜绿假单胞菌(2例)、大肠埃希菌(2例)和阴沟肠杆菌(1例)。金黄色葡萄球菌在大多数样本中占主导地位,在P = 0.023时具有统计学意义。
本研究观察到,与身体其他部位不同,颅颌面区域的微生物菌群具有多样性。对样本进行常规微生物分析和药敏试验对于正确治疗此类病例至关重要。