SEARCH

SEARCH BY CITATION

Keywords:

  • Facial trauma;
  • surgical prophylaxis;
  • antibiotics;
  • zygoma;
  • maxilla;
  • orbit;
  • nasal;
  • alveolar;
  • frontal sinus;
  • palate;
  • tripod;
  • LeFort;
  • Level of Evidence: 2b

Abstract

Objectives/Hypothesis:

Although mandible trauma has been studied extensively, there is no standard for use of pre- and postoperative antibiotics in other facial trauma. We sought to determine whether antibiotic strategies have an effect on infection rates.

Study Design:

Retrospective chart review and cohort analysis.

Methods:

Patients seen by the otolaryngology service for traumatic facial injuries between January 1, 2003 and January 1, 2009, were included in a retrospective cohort analysis (N = 223). All patients received perioperative antibiotic coverage. Isolated mandible fractures were excluded.

Results:

Patient demographics were 73% male and 27% female, with an average age of 35 years (range, 8–81 years). The most common causes of trauma were assault (39%), motor vehicle accidents (28%), and falls (11%). The overall infection rate was 9%. There was no significant difference (P = .248) between infection rates for patients in each antibiotic group (preoperative, postoperative, pre- and postoperative, only perioperative). Infection rate was independently correlated with both number of fractures (P < .0001) and open fracture wounds (P = .034). There was no significant difference in infection rate between patients who received only perioperative antibiotics and those who received additional antibiotics (P = .997). However, the cohort with the most antibiotic use (pre-, peri-, and postoperative) had more severe facial injuries than the cohort that received only perioperative antibiotics.

Conclusions:

The use of additional antibiotics outside the perioperative timeframe does not reduce the rate of postoperative infections; however, such antibiotic use may be warranted in cases of severe facial trauma with multiple open fracture wounds. Laryngoscope, 2010