Al Azhar University, Cairo, Egypt; Taibah University Dental College and Hospital, Al-Madinah Al-Munawwrah, Saudi Arabia.
Al-Azhar University for Boys, Assuit, Egypt.
Wounds. 2021 Mar;33(3):60-64.
The high prevalence of intraoral wound dehiscence (IOWD) following open reduction internal fixation of mandibular fractures has not been well studied.
A retrospective cohort study was conducted to investigate and assess possible risk factors for IOWD related to patients and surgical technique.
All patients who did not have diabetes, were not medically compromised such as patients with nutritional deficiencies or endocrine disorders, did not smoke, did not consume alcohol, and had mandibular fractures managed through open reduction internal fixation and via intraoral vestibular incision from January 2007 to December 2019, at Al-Azhar University Hospitals, in Cairo, Egypt were included in the study. Study data were collected and grouped according to the demographic characteristics of patient age and sex and fracture-related factors of cause, side, site, displacement severity, fixation device, infection, and history of dehiscence. Follow-up of all patients was conducted daily during the first week and weekly during the first month after surgery. Data were analyzed using cross-tabulation with Pearson chi-squared test to calculate the significance of associations between various independent variables and occurrence of IOWD; P less than or equal to .05 was viewed as statistically significant.
The study included 69 mandibular fracture patients (age range, 13-55 years [mean, 28.13 ± 11.5 years]) treated using different osteosynthesis fixation devices, including miniplates, lag screws, and heavy locking plates. No statistically significant differences were noted between groups in terms of age, sex, and surgical attributes of fracture site, displacement severity, or fixation type with regard to IOWD (P > .05). None of the included patients were medically compromised, smoked, or used alcohol. Intraoral wound dehiscence occurred in 7 patients (10.1%) and was managed conservatively through copious irrigation with warm saline and chlorhexidine mouthwash in intermittent cycles of 5 times a day for 2 weeks; when infection was present, antibiotic prescription and drainage were provided. Complete wound closure was achieved after a maximum period of 2 weeks.
A small proportion of mandibular fracture patients are expected to have IOWD complication even if a meticulous and appropriate surgical technique is implemented. Intraoral wound dehiscence has a good prognosis and it may require a maximum of 2 weeks to obtain healing with secondary epithelization of the bared bony sites.
下颌骨骨折切开复位内固定术后，口腔内创口裂开（IOWD）的高发生率尚未得到很好的研究。
本回顾性队列研究旨在调查和评估与患者和手术技术相关的 IOWD 发生的可能危险因素。
所有患者均无糖尿病，无营养缺乏或内分泌紊乱等医学并发症，不吸烟，不饮酒，于 2007 年 1 月至 2019 年 12 月在埃及开罗的艾资哈尔大学医院接受了经口内前庭切口切开复位内固定术治疗的下颌骨骨折患者均纳入本研究。根据患者年龄和性别以及骨折相关因素（病因、侧别、部位、移位严重程度、固定装置、感染和裂开史）的特点收集和分组研究数据。所有患者在术后第一周每天进行随访，在术后第一个月每周进行随访。采用交叉表和 Pearson 卡方检验分析各种独立变量与 IOWD 发生之间的关联的显著性；P 值小于或等于.05 被视为具有统计学意义。
本研究纳入了 69 例下颌骨骨折患者（年龄 13-55 岁[平均 28.13±11.5 岁]），采用不同的接骨板固定装置（微型板、拉力螺钉和重型锁定板）进行治疗。在 IOWD 方面，年龄、性别以及骨折部位、移位严重程度或固定类型等手术属性的组间无统计学差异（P>.05）。所有纳入的患者均无医学并发症、吸烟或饮酒。7 例（10.1%）患者出现口腔内创口裂开，通过大量温生理盐水冲洗和氯己定漱口液间歇性循环（每天 5 次，持续 2 周）进行保守治疗；当出现感染时，给予抗生素处方和引流。最大 2 周后完全闭合创口。
即使采用精细和适当的手术技术，也预计只有一小部分下颌骨骨折患者会出现 IOWD 并发症。口腔内创口裂开具有良好的预后，可能需要最长 2 周时间才能获得愈合，裸露的骨面会进行二期上皮化。
