Does Perioperative Glucocorticosteroid Treatment Correlate With Disturbance in Surgical Wound Healing After Treatment of Facial Fractures? A Retrospective Study

Thorén, Hanna; Snäll, Johanna; Kormi, Eeva; Numminen, Laura; Fäh, Reto; Iizuka, Tateyuki; Lindqvist, Christian; Törnwall, Jyrki

doi:10.1016/j.joms.2009.04.089

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 9 , Pages 1884-1888, September 2009

Does Perioperative Glucocorticosteroid Treatment Correlate With Disturbance in Surgical Wound Healing After Treatment of Facial Fractures? A Retrospective Study

Hanna Thorén, MD, DDS, PhD
- Consultant and Lecturer, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland; and Department of Cranio-Maxillofacial Surgery, Bern University Hospital and University of Bern, Bern, Switzerland
- Address correspondence and reprint requests to Dr Thorén: Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Ch-3010, Bern, Switzerland
Johanna Snäll, DDS
- Resident, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland
Eeva Kormi, DDS
- Resident, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland
Laura Numminen, DDS
- Associate Investigator, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland
Reto Fäh, DDS
- Associate Investigator, Department of Cranio-Maxillofacial Surgery, Bern University Hospital and University of Bern, Bern, Switzerland
Tateyuki Iizuka, MD, DDS, PhD, FEBOMFS
- Professor, Head, and Chair, Department of Cranio-Maxillofacial Surgery, Bern University Hospital and University of Bern, Bern, Switzerland
Christian Lindqvist, MD, DDS, PhD
- Professor, Head, and Chair, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland
Jyrki Törnwall, MD, DDS, PhD
- Consultant, Department of Oral and Maxillofacial Surgery, Helsinki University Central Hospital, and Department of Oral and Maxillofacial Surgery, Institute of Dentistry, Helsinki University, Helsinki, Finland

Purpose

To clarify whether perioperative glucocorticosteroid treatment used in association with repair of facial fractures predisposes to disturbance in surgical wound healing (DSWH).

Patients and Methods

Retrospective review of records of patients who had undergone open reduction, with or without ostheosynthesis, or had received reconstruction of orbital wall fractures during the 2-year period from 2003 to 2004.

Results

Steroids were administered to 100 patients (35.7%) out of a total of 280. Dexamethasone was most often used, with the most common regimen being dexamethasone 10 mg every 8 hours over 16 hours, with a total dose of 30 mg. The overall DSWH rate was 3.9%. The DSWH rate for patients who had received perioperative steroids was 6.0%, and the corresponding rate for patients who did not receive steroids was 2.8%. The difference was not statistically significant. An intraoral surgical approach remained the only significant predictor to DSWH.

Conclusions

With regard to DSWH, patients undergoing operative treatment of facial fractures can safely be administered doses of 30 mg or less of perioperative glucocorticosteroids equivalent to dexamethasone.