Limiting antibiotic prophylaxis in the treatment of maxillofacial fractures: A retrospective, single-center study of 81 patients

Abstract

Abstract Introduction The aim of this study was to investigate the validity of the duration for which we provide antibiotic prophylaxis to maxillofacial fracture patients who undergo open reduction and internal fixation (ORIF) in our hospital by retrospectively reviewing the incidence of surgical site infections (SSIs). Methods The medical records of 83 patients with maxillofacial fractures who underwent ORIF from April 2010 to October 2019 were retrospectively reviewed. The surgeon selected the proper surgical approach to the fracture site depending on the location and type of fractures. ORIF was performed by an intraoral, extraoral, or transconjunctival approach, or a combination of these approaches. No statistical investigation of differences in the method of prophylactic antibiotic administration and the occurrence of SSIs was conducted because of the small sample size. Results This retrospective study included 81 patients (58 males; median age 41 (range: 13–82) years; median BMI 22.4 (range: 16.5–33.6) kg/m2) with maxillofacial fractures. Two patients with infected fractures before operation withdrew from this study. The most common choice of antibiotic prophylaxis was cefmetazole for 2 days, followed by cefmetazole for 1 day. Two patients were diagnosed with an SSI; one was on cefazolin 2\xa0g for 2 days, and the other was on cefmetazole 2–4\xa0g for 2 days. In both cases the infection was successfully controlled, and implant removal was not required. Conclusions In principle, antibiotic prophylaxis for 2 days postoperatively is sufficient in ORIF for maxillofacial fracture, but a multicenter, prospective, randomized study may be required to confirm this.