Rich Matthew D, Jungbauer W Nicholas, Schubert Warren
Division of Plastic Surgery, University of Minnesota, Minneapolis, MN, USA.
University of Minnesota Medical School, Minneapolis, MN, USA.
Craniomaxillofac Trauma Reconstr. 2023 Sep;16(3):239-244. doi: 10.1177/19433875221128535. Epub 2022 Sep 17.
Cross-sectional database analysis.
To define post-operative complication rates in facial fracture repair and to assess this data for patient characteristics which may be associated with post-operative complications.
We performed a retrospective cohort analysis of the National Surgical Quality Improvement Program (NSQIP) database between January 1, 2015, and December 31, 2019. All patients included in this study sample must have (a) been ≥18 years old and (b) underwent surgical repair of a facial fracture during the study period by a plastic surgeon or otolaryngologist. Adverse outcomes at 30 days were characterized into four groups: superficial surgical site infection (SSI), deep SSI, organ space infection, and wound disruption.
In total, 2481 patients met the primary outcome of facial fracture. Among the four fracture types assessed, 1090 fractures (43.9%) were mandibular, 721 were zygomatic (29.1%), 638 were orbital (25.7%), and 32 (1.3%) were Lefort. Of the entire cohort, 25 patients (1.01%) experienced a superficial SSI, 14 patients (.56%) presented with a deep SSI, 25 fractures (1.01%) returned with an organ space infection, and 23 patients (.93%) experienced some type of wound disruption. Smokers had a significantly higher risk of superficial SSIs ( < .05) and organ space infections ( < .05).
The majority of facial fracture patients do not experience post-operative complications. However, smokers and patients with diabetes mellitus were shown to be at an elevated risk of developing complications. Future research should further investigate this relationship and focus on developing interventions to improve post-operative outcomes.
横断面数据库分析。
确定面部骨折修复术后的并发症发生率,并评估这些数据中可能与术后并发症相关的患者特征。
我们对2015年1月1日至2019年12月31日期间的国家外科质量改进计划(NSQIP)数据库进行了回顾性队列分析。本研究样本纳入的所有患者必须满足以下条件:(a)年龄≥18岁;(b)在研究期间由整形外科医生或耳鼻喉科医生进行面部骨折手术修复。30天的不良结局分为四组:表浅手术部位感染(SSI)、深部SSI、器官间隙感染和伤口裂开。
共有2481例患者符合面部骨折的主要结局。在评估的四种骨折类型中,下颌骨骨折1090例(43.9%),颧骨骨折721例(29.1%),眼眶骨折638例(25.7%),Le Fort骨折32例(1.3%)。在整个队列中,25例患者(1.01%)发生表浅SSI,14例患者(0.56%)出现深部SSI,25例骨折(1.01%)出现器官间隙感染,23例患者(0.93%)出现某种类型的伤口裂开。吸烟者发生表浅SSI(P<0.05)和器官间隙感染(P<0.05)的风险显著更高。
大多数面部骨折患者未发生术后并发症。然而,吸烟者和糖尿病患者发生并发症的风险较高。未来的研究应进一步探讨这种关系,并专注于开发改善术后结局的干预措施。