MTReC, or the Maxillofacial Trainee Research Collaborative, is a trainee led and delivered research network covering the whole of the UK. They aim to deliver high quality, clinically relevant, trainee led research. As they have a presence in most Maxillofacial Surgery units in the UK they can achieve wide distribution with excellent uptake and return rates. Projects are proposed, designed and delivered by a team of trainees with support from senior research staff and nurses. Next, they are implemented by our network of trainee regional leads and local collaborators in units across the UK. Everyone's input is recognised in publications with a PubMed listed citation.
Current Project: Use of steroids in airway threatening cervicofacial infection
Our current project aims to assess the usefulness of high dose cortocosteroids in the treatment of airway threatening cervicofacial infections. Most of these infections are caused by teeth. This respresents one of the most common emergency presentations to maxillofacial departments. There is a paucity of evidence in the literature to support current treatment.
The mainstay of treatment is removal of the source of infection (usually a tooth) and drainage of pus through incisions in the mouth or neck. The role of high dose corticosteroids is not clear. Some believe that their use can reduce oedema, shorten length of admission and make airway loss and surgical airway less likely. Our project aims to quantify the usefulness of high dose steroids in this setting.
The project consists of 3 rounds of investigation:
- UK wide audit of current management of cervicofacial infection in maxillofacail units (now complete).
- UK wide prospective data capture of 1000 hospital admissions of airway threatening cervicofacial infections in maxillofacial units (started 6th March 2017).
- Multicentre controlled trial assessing the addition of high dose corticosteroids to standard surgical and medical management of airway threatening cervicofacial infection
We have now completed the first phase (audit of current management) and here is a summary of the key findings:
- 267 questionnaires distributed to 17 maxillofacial units across the UK
- 86 questionnaires distributed at JTG 2016 conference
- Consultants n = 121, Registrar n = 120, SHO n = 61, Unknown n = 22
- High response rate, wide distribution: 91.7% (n=324)
- Widespread use of steroids; >10% routinely prescribe steroids
- Variation in antibiotic regimens
- 23% of patients wait >24 hours to get to theatre
- Clinical equipoise exists
Where can I find out more?
For more information on our current study and the rest of our organisation, please visit our website at www.maxfaxtrainee.co.uk