Evaluation of the Variations in the Levels of Perioperative Inflammatory Markers After Open Reduction and Internal Fixation of Maxillofacial Fractures.

INTRODUCTION: Postoperative infectious complications are commonly encountered in open reduction and internal fixation (ORIF) of maxillofacial fractures. An early diagnosis of infectious processes is the key in preventing morbidity/mortality which could be in the form of loss of hardware and sepsis. To prevent these, various markers of inflammation have been studied in different disciplines of surgery but are found scarce in maxillofacial practice. MATERIAL AND
METHOD: The present study was designed to evaluate the perioperative variations in the levels of inflammatory markers. We analysed temperature, TLC, DLC, ALT, AST and CRP in 50 patients of ORIF. Their values were recorded preoperatively as well as at 24 h, 48 h, third day and seventh day postoperatively. The correlation of inflammatory markers with the type of anaesthesia and length of surgery were also analysed.
RESULTS: The ranges of various markers in the perioperative phase were: temperature (97.6 ºF-99.2 ºF), TLC (5100/mm3-18200/mm3), neutrophils (51-91%), AST (12-86 IU/L), ALT (12-96 IU/L) and CRP (1.2-150 mg/L). Mean values of all the inflammatory markers achieved their peak values within 24 h postoperatively. These values showed a decline thereafter, with the day 3 and day 7 values being even lower than their preoperative values. This fall in the values was highly significant (p < 0.001) except ALT where the fall was significant (p < 0.05). The data obtained could be used as a reference range by the surgeons for monitoring the recovery of the patient. It could also help in timely interception and expeditious management of an infectious episode in the postoperative phase. © The Association of Oral and Maxillofacial Surgeons of India 2018, corrected publication, May 2020.