Intraoperative antibiotics may be effective in elective surgery; there may be an advantage to starting antibiotics preoperatively when there is already an infective focus, such as compound facial fractures. The purpose of this study is to compare preoperative and intraoperative antibiotic prophylaxis in compound facial fractures.
Materials and methods
This is a prospective study conducted over a period of 2 years on 50 patients, who underwent open reduction and rigid internal fixation. The patients were assigned to two groups. The patients in group I received antibiotics at the time of admission. The patients in group II received antibiotics perioperatively at the time of induction of general anesthesia. Postoperatively, the patients were evaluated for the reduction of pain and the presence of infection by assessing the local presence of erythema, swelling, a rise in temperature, and purulent discharge, if any, on a predefined proforma.
Results
A total of 72 fractures were assessed in 50 patients. There was an overall reduction of pain in both the groups. Wound healing status was found to be satisfactory in both the groups.
Conclusion
Wound status and infection rate were evaluated in patients of both the groups. In the study, there was no difference between the two groups on the predecided parameters whether the antibiotics were given either preoperatively or perioperatively.
Clinical significance
It is very essential to have a sound knowledge of the use of antibiotic therapy effectively to prevent the overuse of it and, thereby, help avoid developing resistance to antibiotics in patients.
How to cite this article
Mamthashri V, Reddy BP. Comparison of Preoperative and Perioperative Antibiotic Prophylaxis Regimen in Compound Facial Fractures. J Contemp Dent Pract 2018;19(2):214-220.
Antibiotic prophylaxis against wound infections in oral and maxillofacial surgery. J Oral Maxillofac Surg 1999 Jun;48(6):617-620.
; Evans, JR.; editors. Controversies in oral and maxillofacial surgery. Philadelphia (PA): WB Saunders; 1993. pp. 95-100.
The prophylactic use of antibiotics in head and neck surgery. Otoloryngol Clin North Am 1976 Oct;9(3):781-787.
A study of antibiotic usage in compound mandibular fracture. J Oral Surg 1975;33:431-434.
Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open fractures. Rev Infect Dis 1991 Sep-Oct;13(Suppl 10):S847-S857.
The timing of prophylactic administration of antibiotics and the risk of surgical wound infection. N Engl J Med 1992 Jan;326(5):281-286.
; Gadre, A. Principles of wound management. In: Rob and Smith operative surgery. 4th ed. Philadelphia (PA): Butterworth-Heinemann; 1986. pp. 608-623.
Risk factors for postoperative infections. Am J Med 1991 Sep;91(3B):158S-163S.
National nasocomial infections surveillance system: surgical wound infection rates by wound class operative procedure and patient risk index. Am J Med 1991;91:152S-157S.
The concentration of selected intravenously administered antibiotics in experimental surgical wounds. Ann Surg 1979;12:246.
Susceptibility of anaerobic bacteria in Auckland. N Z Med J 1999 Dec;112:424-426.
Metronidazole compared with penicillin in the treatment of acute dental infections. Br J Oral Surg 1977 Mar;14(3):264-269.
Antimicrobial prophylaxis in oral surgery. Oral and Maxillofac Surg Infect 1992 Sep;2:85-92.
Antibiotic prophylaxis of infective endocarditis. Lancet 1992;339:1292-1293.
Microbiologic and antibiotic aspects of infections in the oral maxillofacial region. J Oral Surg 1979 Dec;37(12):873-882.
Postoperative antibiotic prophylaxis in mandibular fractures: a preliminary, randomized, double-blind and placebo-controlled clinical study. J Oral Maxillofac Surg 2001 Dec;59(12):1415-1419.
; Assael, LA. Topazian's oral and maxillofacial infections. 4th ed. Philadelphia (PA): W.B Saunders; 2002. pp. 366-377.
Preventive antibiotic management in surgery. Ann Rev Med 1973 Feb;24:289-294.