Comparison of Wound Management Methods After Removal of Maxillofacial Osseous Lesions
Purpose
To evaluate outcomes associated with choice of wound management, ie, primary closure or healing by secondary intention, of osseous defects after excision of maxillofacial bone lesions as a guide to clinical practice.
Patients and Methods
Using a retrospective cohort study design, we enrolled a sample composed of subjects treated for jaw lesions between 1995 and 2003. The primary predictor variable was the wound management choice of the residual jaw defect, classified as primary closure or healing by secondary intention. The primary outcome variable was postoperative inflammatory complications. Other study variables were grouped as demographic, medical/dental history, lesion information, preoperative complications, operative treatment, and follow-up information. Appropriate uni-, bi-, and multivariate statistics were computed.
Results
The sample was composed of 93 subjects with 126 jaw lesions, of which 90 (71.4%) were managed by primary closure. In the bivariate analyses, tobacco use was statistically associated (P < .05) with wound management and near statistically associated (P = .06) with complications. In the multivariate model, after adjusting for the presence of multiple cysts and tobacco use, there was not a statistically significant difference between the 2 wound management choices in terms of postoperative complications.
Conclusions
Our results suggest that the choice of managing the osseous wound, ie, primary closure versus secondary intention, was not associated with increased risk of postoperative inflammatory complications. The implications of these findings are discussed below.
⁎Graduate Student in Orthodontics, Department of Oral and Developmental Biology, Harvard School of Dental Medicine, Boston, MA.
†Associate Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Massachusetts General Hospital, Boston, MA.
‡Associate Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Director, Center for Applied Clinical Investigation, Massachusetts General Hospital, Boston, MA.
Address correspondence and reprint requests to Dr Dodson: Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1201, Boston, MA 02114
This research was funded in part by the Oral and Maxillofacial Surgery Research Foundation Student Training Award and the Department of Oral and Maxillofacial Surgery Education and Research Fund.
ABSTRACT