Infectious complications of craniofacial surgery in children.

During the 10-year period 1975 through 1984, 219 children with congenital anomalies underwent oromaxillary or craniofacial surgery at Children's Medical Center, Dallas. There were no infectious complications following 56 oromaxillary procedures. The overall rate of infection following craniofacial surgery was 14.7% (24 of 163). Infection rates were significantly increased when a combined (monoblock) repair was performed (45% [15 of 33]), compared with either intracranial (8% [six of 72]) or extracranial (5% [three of 58]) procedures alone (P less than .001). The variables identified by multivariate discriminant analysis as useful independent predictors of postoperative infection were, in order of decreasing importance: length of operation, type of procedure (intracranial, extracranial, or combined), and age. Staged procedures are recommended for craniofacial surgery whenever possible because of the significant increase in rate of infection associated with the monoblock repair.