DOI QR코드

DOI QR Code

Comparative analysis of the amount of postoperative drainage after intraoral vertical ramus osteotomy and sagittal split ramus osteotomy

  • Kim, Hyunyoung (Department of Oral and Maxillofacial Surgery, Oral Science Research Institute, College of Dentistry, Yonsei University) ;
  • Chung, Seung-Won (Department of Oral and Maxillofacial Surgery, Oral Science Research Institute, College of Dentistry, Yonsei University) ;
  • Jung, Hwi-Dong (Department of Oral and Maxillofacial Surgery, Oral Science Research Institute, College of Dentistry, Yonsei University) ;
  • Park, Hyung-Sik (Department of Oral and Maxillofacial Surgery, Oral Science Research Institute, College of Dentistry, Yonsei University) ;
  • Jung, Young-Soo (Department of Oral and Maxillofacial Surgery, Oral Science Research Institute, College of Dentistry, Yonsei University)
  • Received : 2014.05.15
  • Accepted : 2014.06.18
  • Published : 2014.08.29

Abstract

Objectives: The purpose of this retrospective study was to compare the amount of postoperative drainage via closed suction drainage system after intraoral vertical ramus osteotomy (IVRO) and sagittal split ramus osteotomy (SSRO). Materials and Methods: We planned a retrospective cohort study of 40 patients selected from a larger group who underwent orthognathic surgery from 2007 to 2013. Mean age (range) was 23.95 (16 to 35) years. Patients who underwent bilateral IVRO or SSRO were categorized into group I or group II, respectively, and each group consisted of 20 patients. Closed suction drainage system was inserted in mandibular osteotomy sites to decrease swelling and dead space, and records of drainage amount were collected. The data were compared and analyzed with independent t-test. Results: The closed suction drainage system was removed at 32 hours postoperatively, and the amount of drainage was recorded every 8 hours. In group I, the mean amount of drainage was 79.42 mL in total, with 31.20 mL, 19.90 mL, 13.90 mL, 9.47 mL, and 4.95 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. In group II, the mean total amount of drainage was 90.11 mL, with 30.25 mL, 25.75 mL, 19.70 mL, 8.50 mL, and 5.91 mL measured at 0, 8, 16, 24, and 32 hours postoperatively, respectively. Total amount of drainage from group I was less than group II, but there was no statistically significant difference between the two groups (P=0.338). There was a significant difference in drainage between group I and group II only at 16 hours postoperatively (P=0.029). Conclusion: IVRO and SSRO have different osteotomy design and different extent of medullary exposure; however, our results reveal that there is no remarkable difference in postoperative drainage of blood and exudate.

Keywords

References

  1. Ovington LG. Dealing with drainage: the what, why, and how of wound exudate. Home Healthc Nurse 2002;20:368-74.
  2. Jones J, Barraud J. An evaluation of KerraMax Care in the management of moderate to heavily exuding wounds. Br J Community Nurs 2014;(Suppl):S48, S50-3.
  3. Politis C, Kunz S, Schepers S, Vrielinck L, Lambrichts I. Obstructive airway compromise in the early postoperative period after orthognathic surgery. J Craniofac Surg 2012;23:1717-22.
  4. Hwang K, Kim HJ, Lee HS. Airway obstruction after orthognathic surgery. J Craniofac Surg 2013;24:1857-8.
  5. Yoshioka I, Khanal A, Tominaga K, Horie A, Furuta N, Fukuda J. Vertical ramus versus sagittal split osteotomies: comparison of stability after mandibular setback. J Oral Maxillofac Surg 2008;66:1138-44.
  6. Abou-Khalil R, Colnot C. Cellular and molecular bases of skeletal regeneration: what can we learn from genetic mouse models? Bone 2014;64:211-21.
  7. Clifton R, Haleem S, McKee A, Parker MJ. Closed suction surgical wound drainage after hip fracture surgery: a systematic review and meta-analysis of randomised controlled trials. Int Orthop 2008;32:723-7.
  8. He XD, Guo ZH, Tian JH, Yang KH, Xie XD. Whether drainage should be used after surgery for breast cancer? A systematic review of randomized controlled trials. Med Oncol 2011;28(Suppl 1):S22-30.
  9. Ueki K, Marukawa K, Shimada M, Nakagawa K, Yamamoto E. The assessment of blood loss in orthognathic surgery for prognathia. J Oral Maxillofac Surg 2005;63:350-4.
  10. Morsi E. Continuous-flow cold therapy after total knee arthroplasty. J Arthroplasty 2002;17:718-22.
  11. Song G, Yang P, Hu J, Zhu S, Li Y, Wang Q. The effect of tranexamic acid on blood loss in orthognathic surgery: a meta-analysis of randomized controlled trials. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:595-600.
  12. Zellin G, Rasmusson L, Pålsson J, Kahnberg KE. Evaluation of hemorrhage depressors on blood loss during orthognathic surgery: a retrospective study. J Oral Maxillofac Surg 2004;62:662-6.
  13. Choi WS, Irwin MG, Samman N. The effect of tranexamic acid on blood loss during orthognathic surgery: a randomized controlled trial. J Oral Maxillofac Surg 2009;67:125-33.
  14. Chegini S, Dhariwal DK. Review of evidence for the use of steroids in orthognathic surgery. Br J Oral Maxillofac Surg 2012;50: 97-101.
  15. Weber CR, Griffin JM. Evaluation of dexamethasone for reducing postoperative edema and inflammatory response after orthognathic surgery. J Oral Maxillofac Surg 1994;52:35-9.