scholarly journals Wound Closure and Care in Oral and Maxillofacial Surgery

Author(s):  
Ravi Veeraraghavan

AbstractManagement of soft tissue wounds needs a careful assessment of the wound, a good understanding of wound types and healing as well as adequate knowledge and skill for wound care. The various steps in wound care include cleansing and debridement, haemostasis, tetanus immunisation and antibiotic medication and wound closure.Wound closure can be accomplished in diverse ways, but suturing remains the mainstay. A wide variety of materials are available for wound suturing. One has to choose the right material and technique depending on the wound type and closure needs. Alternate techniques such as staples, tapes and adhesives are fast gaining popularity.

2020 ◽  
Author(s):  
Juncar Raluca Iulia ◽  
Paul Andrei Tent ◽  
Juncar Mihai ◽  
Arghir Ioan Anton ◽  
Arghir Cristina Oana ◽  
...  

Abstract Background: The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. We will use these results in order to improve the diagnosis and the establishment of correct treatment of this pathology. Methods: A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Statistical analysis was performed with the MedCalc Statistical Software version 19.2 (MedCalc Software bvba, Ostend, Belgium;53 https://www.medcalc.org; 2020). Nominal data were expressed as frequency and percentage. The comparisons of the frequencies of a nominal variable among the categories of another nominal variable were made using the chi-square test. Multivariate logistic regressions were used in order to establish the independent association between variables and lacerations/excoriations. After using the Bonferroni correction for multiple comparisons, a value of p<0.025 was considered statistically significant.Results: The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n=179 (73.9%), closed n=179 (73.9%) and complete n=219 (90.5%). Hematoma was the most frequent associated soft tissue lesion n=102 (42.1%) regardless of the fracture pattern (p=1.000). Complete zygomatic fracture (OR – 2.68; p=0.035) and fractures with displacement (OR – 3.66; p=0.012) were independently associated with the presence of laceration. Fractures with displacement (OR – 7.1; p=0.003) were independently associated with the presence of excoriation. The most frequent type of treatment applied was Gillies reduction (61.9%), followed by ORIF (30.9%). The most frequent postoperative complication was malunion secondary to Gillies treatment (4,6%). Conclusions: Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. In the case of displaced, open or comminuted fractures we achieved the best results secondary to ORIF treatment method, while in the case of non-displaced and closed fractures, the best results achieved were secondary to conservative treatment.


2018 ◽  
Vol 32 (3) ◽  
pp. 154
Author(s):  
Fernando De Oliveira Andriola ◽  
Leonardo Matos Santolim Zanettini ◽  
Ricardo Giacomini De Marco ◽  
Camila Kunz ◽  
Cássia Dos Santos Machado Vaz ◽  
...  

OBJECTIVE: This article presents a case of inflammatory fibrous hyperplasia (IFH) treated by diode laser surgery, as well as a review of the literature about this pathology.CASE DESCRIPTION: A 55-year-old woman was referred to the Department of Oral and Maxillofacial Surgery, Pontifical Catholic University of Rio Grande do Sul, School of Dentistry, complaining of a discomfort on swallowing due to a soft-tissue mass in the oral cavity that had been developing for approximately 3 years. Intraoral examination revealed multiple exophytic, pedunculated lesions with a smooth surface and pinkish in color, affecting almost the entire right cheek mucosa. The lesion turned out to be a IFH by histopatology. Surgical removal of IFH of the oral mucosa using a diode laser was performed. The lesion was removed in 3 sessions. The patient reported no local symptoms after each irradiation. The clinical appearance 10 months after the last irradiation session demonstrated complete healing and no signals of recurrence.CONCLUSION: Based on the results obtained, we can conclude that diode laser radiation contributes significantly to the advancement of oral surgery and should be considered a valuable resource for the treatment of soft-tissue lesions in the field of oral and maxillofacial surgery.


Author(s):  
Luke Cascarini ◽  
Clare Schilling ◽  
Ben Gurney ◽  
Peter Brennan

This chapter discusses oral and maxillofacial surgery in the A&E department, including, The paediatric OMFS patient, Overview of maxillofacial trauma, Mandibular fractures, Zygomatic fractures, Orbital floor fractures, Maxillary fractures, Nose, naso-ethmoidal, and frontal bone fractures, Face and scalp soft tissue injuries, Penetrating injuries to the neck, Intra-oral injuries, Dento-alveolar trauma, Dento-alveolar infections, Post-extraction complications, Head and neck soft tissue infections, Salivary gland diseases, and Miscellaneous conditions


2020 ◽  
Vol 13 (4) ◽  
pp. e232850
Author(s):  
Lwazi Sibanda ◽  
Emma Wates ◽  
James Higginson

Actinomycosis is an uncommon, chronic suppurative granulomatous infection and needs to be considered as a differential diagnosis. A 56-year-old woman with a background of type 2 diabetes mellitus and breast carcinoma was referred to the Oral and Maxillofacial Surgery 2-week wait clinic, regarding a tender sublingual mass and firm erythematous swelling in the right submandibular and submental region. This was slowly progressive and had not responded to oral co-amoxiclav. An orthopantomogram showed a well-defined radiolucency and smaller radiolucent lesions throughout the edentulous right body of the mandible. A contrast-enhanced CT confirmed a right submandibular abscess communicating with cavitating lesions. The differentials included osteomyelitis, bony metastases, multiple myeloma or other cystic lesions. The patient underwent incision and drainage of the abscess, alongside biopsies, and intravenous co-amoxiclav was given. Microbiology cultures confirmed the presence of Actinomyces israelii and a diagnosis of cervicofacial actinomycosis with mandibular osteomyelitis. The patient was successfully treated with prolonged antibiotics.


2020 ◽  
Vol 12 (45) ◽  
pp. 53-58
Author(s):  
Luiz Henrique de Melo Nogueira ◽  
Luciano Henrique Ferreira Lima ◽  
Beneval José dos Santos Junior ◽  
André Vitor Alves Araújo

Synovial chondromatosis (SC) is a rare pathological condition that is characterized by the formation of cartilaginous nodules inside a joint cavity. It mainly affects the knee joints, hip, shoulder, and elbow, so the TMJ is rarely the target of such condition. Its etiology is still unknown and is usually diagnosed through magnetic resonance imaging (MRI), computed tomography (CT), histopathological exams, and, in some cases, arthroscopy, once the clinical inspection normally is not enough to conclude the diagnose. This study reports a case of a 35-year-old man that came to the Oral and Maxillofacial Surgery service complaining about limited mouth opening, occlusal dystopia, and increase of volume on the right pre-auricular region associated to pain. The SC diagnosis was suggested after realizing a CT and MRI. An Al-Kayat approach was performed to fully visualize the TMJ, removal of all the cartilaginous fragments, hemostasis and suture by layers. The diagnosis was confirmed through the histopathological exam. The patient evolved asymptomatic.


2021 ◽  
pp. 62-65
Author(s):  
S.P. Indra Kumar ◽  
Kavin T ◽  
Narendar R ◽  
E. Gayathri Priyadharshini ◽  
Akshaya murugan ◽  
...  

AIM: The aim of this study is to comparatively evaluate the post extraction socket healing clinically and radiographically with and without using Platelet Rich Fibrin (PRF). MATERIALS AND METHODS: Fifty, otherwise healthy individuals undergoing dental treatment in the department of Oral and Maxillofacial surgery, Vivekananda Dental College for women, Thiruchengode, were randomly selected and the participants were divided into two groups – test group(PRF, n=25) and control group (Blood clot, n=25). Blood was freshly obtained from the participants of the test group and PRF was prepared. PRF was placed in the sockets of the test group and followed by the pressure application and suturing. Control group were allowed to heal naturally. Clinically, soft tissue healing and socket closure were assessed. Radiographic analysis of socket healing done by comparison of pre- and post-operative radiographs. The clinical follow-up assessments were done at an interval of 3 days, 1 week and 4 weeks and the data obtained were assessed. The patients were aged above 18 years, i RESULT: ncluding 33 females and 17 males. The soft tissue and socket healing were higher in the test group when compared with the control group clinically and the mean proportion of radiographic bone ll was signicantly higher in the test group in all the time intervals of 3 days, 1 week and 4 weeks, respectively. Outcome of the study CONCLUSION: demonstrate that the PRF placement in the extraction socket accelerates soft tissue healing and socket healing and increases the bone ll and reduces the bone resorption using clinical and radiographic methods.


2010 ◽  
Vol 3 (5) ◽  
pp. 269-273 ◽  
Author(s):  
Claire M. Capobianco ◽  
Thomas Zgonis

Midfoot ulceration is a common sequela of the diabetic Charcot rocker-bottom deformity. Because redundant soft tissue from a non— weight-bearing area is often scarce in this area of the foot, soft-tissue coverage may be challenging. Wound closure may be difficult to achieve with local wound care and off-loading techniques if the predisposing deformity that caused the ulceration is not addressed. In the same setting, surgical reconstruction is often feared when open wounds are present, given the potential for infection. Approaching these wounds with a rational stepwise and staged approach is prudent to eradicate the underlying infection and also to achieve durable wound closure and long-term deformity correction. The authors present the use of a local muscle flap and circular external fixation for closure of a recalcitrant Charcot plantar-medial midfoot ulceration and also discuss different adjunctive modalities to facilitate soft-tissue reconstruction in the diabetic foot.


2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Rafael Correia Cavalcante ◽  
Isabela Polesi Bergamaschi ◽  
Aline Monise Sebastiani ◽  
Fabiano Galina ◽  
Marina Fanderuff ◽  
...  

Introduction. Class II division I malocclusions are the most common dentofacial deformities seen in clinical practice. Severe cases or cases in which growth has ceased may require full correction combining orthodontic and surgical treatment. We report a case of a total mandibular subapical alveolar osteotomy, performed to correct a class II division I dentofacial deformity. Case Report. A 19-year-old female patient was referred to the oral and maxillofacial surgery department at the Federal University of Paraná with chin aesthetic complaints as well as class II malocclusion. The proposed treatment was total mandibular subapical alveolar osteotomy, retaining the chin position and eliminating the need for genioplasty, since, although the patient presented with a class II dentofacial deformity, the chin was well positioned. Under general anesthesia, a “V-shaped” incision was conducted from the right retromolar region to the left retromolar region. A ring of cortical bone was removed around the mental foramen, with the aim to create a space around the mental nerve. Fixation was conducted with plates and screws of the 2.0 system. The patient on six-year follow-up showed osteotomy stability, a better overall occlusion, and outcome satisfaction.


2020 ◽  
Author(s):  
Juncar Raluca Iulia ◽  
Paul Andrei Tent ◽  
Juncar Mihai ◽  
Arghir Ioan Anton ◽  
Arghir Cristina Oana ◽  
...  

Abstract Background The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions, which make clinical diagnosis and therapeutic indications difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue lesions, in order to improve the diagnosis and the establishment of the correct treatment. We also aimed to assess the type of treatment methods applied depending on the fracture pattern of the zygomatic bone, as well as their effectiveness depending on the incidence rate of postoperative complications. Methods A 10-year retrospective evaluation of midface fractures was performed in patients diagnosed and treated in a tertiary Clinic of Oral and Maxillofacial Surgery. Results The study included 242 patients with zygomatic bone fractures. The majority of the fractures were displaced n = 179 (73.90%), closed n = 179 (73.90%) and complete n = 219 (90.50%). Hematoma was the most frequent associated soft tissue lesion n = 102 (42.15%) regardless of the fracture pattern (p = 1.000). The incidence of lacerations and excoriations was statistically higher in the case of complete (laceration p = 0.0028/ excoriation p = 0.037), displaced and comminuted zygomatic fractures (laceration p = 0.015/ excoriation p = 0.001). The most frequent type of treatment applied was Gillies reduction (61.98%), followed by ORIF (30.99%). The most frequent postoperative complication was malunion secondary to Gillies treatment (p = 002). Conclusions Patients presenting lacerations and excoriations on clinical soft tissue examination will most frequently have an underlying complete, displaced or comminuted zygomatic fracture. The most effective treatment method in the case of displaced, open or comminuted fractures was ORIF, while in the case of non-displaced and closed fractures, conservative treatment was the most effective.


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