Satnam Kaur, Chandni Shah, Indran Balasundaran
In the UK, it is current practice not to remove mandibular plates following fixation unless complications arise. With little research on this topic we decided to base our audit on the rate of acutely infected mandible fractures following surgical intervention at Northwick Park Hospital. The aim was to identify the number of infected mandibles and to establish any contributing factors related to infection in order to make improvements to current practice.
A standard was set at 10% for the rate of acute infection following surgical intervention of mandibular fractures. Retrospective data was gathered in a twelve month period from a number of sources including handovers, Mortality and Morbidity minutes, A&E notes and patient records. This was collected onto a formulated data capture sheet and contributing risk factors were analysed.
During a 12 month period between October 2015 to September 2016, over 250 patients were admitted with mandibular fractures. Approximately 90% had surgical intervention of which over 10% returned with an acute infection. Factors analysed included patient demographics, social factors, nature of the mandibular fracture and operative factors.
A number of contributing factors have been identified. One of the most common factors identified was post-operative care e.g. smoking immediately after treatment and poor oral hygiene. The audit has allowed us to identify a current lack of emphasis on post-operative instructions. As a result to try and improve this we were able to create tailored post-operative leaflets and advice for these patients.