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Is Resident Participation Associated With Complications in Isolated Maxillofacial Fracture Repair?
Lang Liang1, Tim T Wang2, Nicholas Wilken3
1DMD Candidate, Harvard School of Dental Medicine, Boston, MA.
Summary
Resident participation in maxillofacial fracture surgery did not increase complications but did lengthen operative time. These findings support surgical training while highlighting efficiency improvements in academic settings.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Education
- Trauma Surgery
Background:
- Resident participation in surgery is linked to longer operative times, but its effect on clinical outcomes is debated.
- This relationship is understudied in maxillofacial trauma, a key area of oral and maxillofacial surgery training.
Purpose of the Study:
- To assess the association between resident involvement and perioperative outcomes in open reduction and internal fixation of maxillofacial fractures.
- To determine if resident participation impacts complication rates and operative time.
Main Methods:
- Retrospective cohort study using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2005-2012).
- Included patients undergoing open reduction and internal fixation of a single maxillofacial fracture; excluded those under 18 or with missing data.
- Analyzed resident participation as the predictor variable and 30-day postoperative complications, operative time, and return to operating room as outcomes.
Main Results:
- A total of 746 patients were included; 60.9% had resident participation.
- Overall complication rate was 3.6%, with no significant difference between cases with (4.4%) and without (2.4%) residents (RR 1.84; P = .1).
- Resident participation was not associated with increased complications or return to the OR, but mean operative time was 45% longer (136 vs 94 minutes, P < .001).
Conclusions:
- Resident participation in maxillofacial fracture surgery is not linked to higher complication rates.
- Surgical trainees' involvement is associated with increased operative time, suggesting a need for efficiency improvements in academic settings.
- Findings support the continued role of surgical trainees in patient care.
