Abstract
Objective To evaluate the need for antibiotic prophylaxis in orthognathic surgery. Design Double-blind, randomised, controlled trial. Intervention Patients undergoing Le Fort I osteotomy with various mandibular osteotomies were randomised to receive either amoxycillin clavulanic acid (AC), cefuroxime (CF) or placebo (P) intravenously 30 minutes before surgery. Outcome measures Appearance of the wound at day 3 and 7 and at 1 month were assessed by a clinician not involved with the surgery using the following four categories: normal, oedematous, exudate with drainage of non-purulent material, or abscess with drainage of purulent material. Wound dehiscence was scored separately. Results Fifty-four patients were treated over the study period, of whom 15 developed infection. There was a statistically significant increased risk of infectious complication with no antibiotic prophylaxis. Calculating the NNT you would only need to provide antibiotic cover to three patients to prevent one patient suffering an infectious complication. Conclusion There is a statistically significant increased risk of having an infectious complication after orthognathic surgery if no antibiotic prophylaxis is given.
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