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Risk factors for infection following operative treatment of mandibular fractures: a multivariate analysis
I E Stone1, T B Dodson, R A Bays
1Department of Surgery, Emory University School of Medicine, Atlanta, GA.
Abstract:
Utilizing a retrospective study design and a study sample of 284 consecutive patients, we measured the association between five different risk factors and the development of infection following the operative management of mandibular fractures. The five risk factors analyzed were age, sex, number of fractures per patient, time from admission to treatment, and treatment modality. The overall infection rate was 5.3 percent. The infection rate for each treatment modality was (1) 0 percent for closed reduction, (2) 20.0 percent for open reduction and internal fixation with wire osteosynthesis, and (3) 6.3 percent for open reduction and rigid internal fixation. To measure the association between the various risk factors and postoperative infection, we used multivariate logistic regression. After controlling for potential confounding variables, the only risk factor statistically associated with postoperative infection was treatment modality.
Insights
Infection after mandibular fracture surgery is linked to treatment type. Open reduction with wire fixation had the highest infection rate (20%), while closed reduction had none.
Area of Science:
- Oral and Maxillofacial Surgery
- Infectious Disease Research
- Trauma Surgery
Background:
- Postoperative infection is a significant complication following operative management of mandibular fractures.
- Identifying risk factors is crucial for improving patient outcomes and surgical protocols.
Purpose of the Study:
- To investigate the association between specific risk factors and the incidence of infection after surgical treatment of mandibular fractures.
- To determine which factors, if any, are independently associated with postoperative infection.
Main Methods:
- Retrospective study of 284 consecutive patients undergoing operative management of mandibular fractures.
- Analysis of risk factors including age, sex, fracture count, time to treatment, and treatment modality.
- Multivariate logistic regression used to assess the association between risk factors and infection development.
Main Results:
- The overall postoperative infection rate was 5.3%.
- Infection rates varied significantly by treatment modality: 0% for closed reduction, 20.0% for open reduction with wire osteosynthesis, and 6.3% for open rigid internal fixation.
- Multivariate analysis identified treatment modality as the sole statistically significant risk factor for infection.
Conclusions:
- Treatment modality is a critical determinant of postoperative infection risk in mandibular fracture surgery.
- Open reduction techniques, particularly with wire osteosynthesis, are associated with higher infection rates compared to closed reduction.
- Further research may focus on optimizing surgical techniques to minimize infection risk.