The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Thomas W Carver - One of the best experts on this subject based on the ideXlab platform.
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antibiotic duration and outcome complications for surgical site infection prevention in traumatic mandible Fracture
Journal of Surgical Research, 2020Co-Authors: Savo Bou Zein Eddine, Kaitlin Cooper Johnson, Forrest Ericksen, Carolyn C Brookes, William Peppard, Sara Revolinski, Thomas W CarverAbstract:Abstract Background The appropriate duration of antibiotic therapy for surgical site infection (SSI) prevention in traumatic Mandibular Fracture repair is unknown, and practices vary significantly. The objective of this study was to characterize antibiotic duration and outcomes after surgical repair of traumatic Mandibular Fracture. Methods A single-center, retrospective analysis of all adult patients who underwent surgical fixation of a mandible Fracture between January 2014 and December 2016 was performed. Operative service was categorized between otolaryngology (ear, nose, and throat surgery), plastic and reconstructive surgery, and oral and maxillofacial services. Primary outcomes were SSI and operative complications (including osteomyelitis, nonunion, malocclusion, and hardware infections). Differences in antibiotic prescription pattern were analyzed using analysis of variance test and Pearson chi-squared test. Results A total of 75 patients were included in the study with 33 (44.0%), 26 (34.7%), and 16 (21.3%) managed by plastic and reconstructive surgery, ear, nose, and throat surgery, and oral and maxillofacial services, respectively. Median age was 30.0 y. Median injury severity score was 4.0. There was no significant difference in hospital length of stay (P = 0.44), intensive care unit length of stay (P = 0.53), or postoperative complications (P = 0.15). None of our patients developed an SSI or postantibiotics complications. Although the total inpatient duration of antibiotics was not significantly different among services (P = 0.37), there were significant differences in outpatient duration of antibiotics (P = 0.007) and total duration of antibiotics (P = 0.003). Conclusions Duration of antibiotics is not associated with postoperative SSI or antibiotics-related complications. The wide variation in prescribing practices and lack of any clear benefit for prolonged antibiotics provides an opportunity to explore the benefits of a standardized short course of antibiotics. Level of evidence Therapeutic study, III.
Sabrina Cugno - One of the best experts on this subject based on the ideXlab platform.
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resorbable implants for Mandibular Fracture fixation a systematic review and meta analysis
Plastic and reconstructive surgery. Global open, 2019Co-Authors: Yehuda Chocron, Alain J Azzi, Sabrina CugnoAbstract:The mandible represents one of the most common sites of involvement for adult craniofacial trauma.1,2 Mandibular Fractures most commonly occur in young adults following blunt trauma such as motor vehicle accidents, assault, and falls.3 Given that this population engages in at risk behaviors, there is an increased susceptibility to postoperative complications, making prompt diagnosis and management a necessity.4 In the majority of cases, rigid fixation is required to ensure maintenance of proper occlusion and Fracture stabilization while minimizing the risk of infection.1,4 In select cases, namely nondisplaced Fractures without evidence of malocclusion or Fracture mobility, conservative management with a soft diet may be sufficient.1,5 Historically, open reduction and internal fixation (ORIF) for traumatic Mandibular Fractures has been achieved through the use of metallic plates, namely titanium. Metallic implants carry the benefit of providing the necessary tensile strength to withstand forces of mastication while limiting Fracture mobility. However, metallic plates can be palpable, which necessitates secondary surgery for removal and have been associated with interference of radiologic examinations, possible hardware migration, thermal sensitivity, osteolysis, corrosion, and peri-implant soft tissue reactions.6–10 Concerns regarding the use of metallic fixation devices led to the advent of resorbable materials, which were initially developed to avoid secondary surgery for implant removal.11 Early monomeric forms of biodegradable implants, namely poly-L-lactide, were associated with delayed degradation (>5 years), which led to reports of foreign-body reactions, local fistulas, osteolytic lesions, and peri-implant fluctuant swelling.7,12,13 However, with the development of advanced copolymers, self-reinforcing materials, and increased control over degradation rates, recent studies have shown promising results.14,15 In light of this recent evidence, and the increasing use of biodegradable implants for Mandibular Fracture fixation, it is of great value to shed light on overall complication rates and long-term functional outcomes. Given that the literature is devoid of any recent comprehensive reviews comparing outcomes of resorbable and metallic implants for fixation of Mandibular Fractures, we sought to synthesize the available data in an effort to offer an evidence-based view to guide clinical management.
Ruud R M Bos - One of the best experts on this subject based on the ideXlab platform.
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non imf Mandibular Fracture reduction techniques a review of the literature
Journal of Cranio-maxillofacial Surgery, 2017Co-Authors: Enkhorchlon Batbayar, Baucke Van Minnen, Ruud R M BosAbstract:Abstract Background Intermaxillary fixation (IMF) techniques are commonly used in Mandibular Fracture treatment to reduce bone fragments and re-establish normal occlusion. However, non-IMF reduction techniques such as repositioning forceps may be preferable due to their quick yet adequate reduction. The purpose of this paper is to assess which non-IMF reduction techniques and reduction forceps are available for Fracture reduction in the mandible. Methods A systematic search was performed in the databases of Pubmed and EMBASE. The search was updated until February 2016 and no initial date and language preference was set. Results 14 articles were selected for this review, among them ten articles related to reduction forceps and four articles describing other techniques. Thus, modification and design of reduction forceps and other reduction techniques are qualitatively described. Conclusion Few designs of repositioning forceps have been proposed in the literature. Quick and adequate reduction of Fractures seems possible with non-IMF techniques resulting in anatomic repositioning and shorter operation time, especially in cases with good interfragmentary stability. Further development and clinical testing of reduction forceps is necessary to establish their future role in maxillofacial Fracture treatment.
Savo Bou Zein Eddine - One of the best experts on this subject based on the ideXlab platform.
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antibiotic duration and outcome complications for surgical site infection prevention in traumatic mandible Fracture
Journal of Surgical Research, 2020Co-Authors: Savo Bou Zein Eddine, Kaitlin Cooper Johnson, Forrest Ericksen, Carolyn C Brookes, William Peppard, Sara Revolinski, Thomas W CarverAbstract:Abstract Background The appropriate duration of antibiotic therapy for surgical site infection (SSI) prevention in traumatic Mandibular Fracture repair is unknown, and practices vary significantly. The objective of this study was to characterize antibiotic duration and outcomes after surgical repair of traumatic Mandibular Fracture. Methods A single-center, retrospective analysis of all adult patients who underwent surgical fixation of a mandible Fracture between January 2014 and December 2016 was performed. Operative service was categorized between otolaryngology (ear, nose, and throat surgery), plastic and reconstructive surgery, and oral and maxillofacial services. Primary outcomes were SSI and operative complications (including osteomyelitis, nonunion, malocclusion, and hardware infections). Differences in antibiotic prescription pattern were analyzed using analysis of variance test and Pearson chi-squared test. Results A total of 75 patients were included in the study with 33 (44.0%), 26 (34.7%), and 16 (21.3%) managed by plastic and reconstructive surgery, ear, nose, and throat surgery, and oral and maxillofacial services, respectively. Median age was 30.0 y. Median injury severity score was 4.0. There was no significant difference in hospital length of stay (P = 0.44), intensive care unit length of stay (P = 0.53), or postoperative complications (P = 0.15). None of our patients developed an SSI or postantibiotics complications. Although the total inpatient duration of antibiotics was not significantly different among services (P = 0.37), there were significant differences in outpatient duration of antibiotics (P = 0.007) and total duration of antibiotics (P = 0.003). Conclusions Duration of antibiotics is not associated with postoperative SSI or antibiotics-related complications. The wide variation in prescribing practices and lack of any clear benefit for prolonged antibiotics provides an opportunity to explore the benefits of a standardized short course of antibiotics. Level of evidence Therapeutic study, III.
Yehuda Chocron - One of the best experts on this subject based on the ideXlab platform.
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resorbable implants for Mandibular Fracture fixation a systematic review and meta analysis
Plastic and reconstructive surgery. Global open, 2019Co-Authors: Yehuda Chocron, Alain J Azzi, Sabrina CugnoAbstract:The mandible represents one of the most common sites of involvement for adult craniofacial trauma.1,2 Mandibular Fractures most commonly occur in young adults following blunt trauma such as motor vehicle accidents, assault, and falls.3 Given that this population engages in at risk behaviors, there is an increased susceptibility to postoperative complications, making prompt diagnosis and management a necessity.4 In the majority of cases, rigid fixation is required to ensure maintenance of proper occlusion and Fracture stabilization while minimizing the risk of infection.1,4 In select cases, namely nondisplaced Fractures without evidence of malocclusion or Fracture mobility, conservative management with a soft diet may be sufficient.1,5 Historically, open reduction and internal fixation (ORIF) for traumatic Mandibular Fractures has been achieved through the use of metallic plates, namely titanium. Metallic implants carry the benefit of providing the necessary tensile strength to withstand forces of mastication while limiting Fracture mobility. However, metallic plates can be palpable, which necessitates secondary surgery for removal and have been associated with interference of radiologic examinations, possible hardware migration, thermal sensitivity, osteolysis, corrosion, and peri-implant soft tissue reactions.6–10 Concerns regarding the use of metallic fixation devices led to the advent of resorbable materials, which were initially developed to avoid secondary surgery for implant removal.11 Early monomeric forms of biodegradable implants, namely poly-L-lactide, were associated with delayed degradation (>5 years), which led to reports of foreign-body reactions, local fistulas, osteolytic lesions, and peri-implant fluctuant swelling.7,12,13 However, with the development of advanced copolymers, self-reinforcing materials, and increased control over degradation rates, recent studies have shown promising results.14,15 In light of this recent evidence, and the increasing use of biodegradable implants for Mandibular Fracture fixation, it is of great value to shed light on overall complication rates and long-term functional outcomes. Given that the literature is devoid of any recent comprehensive reviews comparing outcomes of resorbable and metallic implants for fixation of Mandibular Fractures, we sought to synthesize the available data in an effort to offer an evidence-based view to guide clinical management.