• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.4.1-4.4
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• 2020

Background: Odontogenic cysts associated with lower third molar are common. The prognosis for surgical treatment is relatively good. However, postoperative infection discourages the clinicians. Hence, we would like to investigate the factors associated with infection after surgical treatment of cysts associated with the mandibular third molar. Methods: We retrospectively reviewed the medical and radiographic records of 81 patients who were diagnosed with dentigerous cyst or odontogenic keratocyst and underwent cyst enucleation. The factors affecting postoperative infection were divided into host factor, treatment factor, and cystic lesion factor. To identify the factors associated with postoperative infection, we attempted to find out the variables with significant differences between the groups with and without infection. Results: A total of 81 patients (64 male and 17 female) were enrolled in this study. There was no statistical relationship about the postoperative infection between all variables (gender, smoking, diabetes mellitus, age, bone grafting, related tooth extraction, previous marsupialization or decompression, type of antibiotics, cortical perforation associated with cystic lesion, preoperative infection, preoperative cyst size). Conclusions: The results of this study suggest that it is not necessary to avoid bone grafts that are concerned about postoperative infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.217-225
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• 2001

Any fracture passing through the socket of a teeth is compounded intraorally, even if the fracture is not displaced and the tooth is firm in its socket. Before the advent of antibiotic therapy the danger of infection in a compounded fracture posed severe problems in treatment. Infection is reduced by antibiotic therapy but prolonged use of antibiotics is not justified in an attempt to save a tooth which might eventually be sacrificed. There is still controversy in the management of third molar in mandibualr angle fracture, particulary in regard to their retention or removal at the time of fracture treatment. So we surveyed the 159 patients who were treated with open reduction of mandibular angle fracture containing third molar in fracture line, and compared with the postoperative infection rate depending on time intervals between injury and operation, eruption state of third molar, non-extraction or extraction of third molar related to eruption state, non-extraction or extraction of third molar related to condiition of third molar and its surrounding periodontium and were to propose treatment guidline of third molar in mandibular angle fracture The results obtained were as follows : 1. There were no statistical significance between the time from injury to operation and postoperative infection. 2. There were no statistical significance between eruption state of third molar and postoperative infection. 3. In case of retention of the third molar, there were no statistical significance between eruption state of third molar and postoperative infection, but in case of extraction, postoperative infection was high rate in complete impacted cases. 4. There were no statistical significance between non-extraction or extraction of third molar and postoperative infection depending on condition of third molar. There are no difference in infection rate statistically according to the time from injury to operation, eruption state and condition of third molar, but retention of third molar revealed lowered infection rate in completely impacted cases. By terms of the manegement of third molar, we should extract or preserve third molar in the line of the mandibular angle fracture according to possibility of infection.

• Journal of Periodontal and Implant Science
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• 제40권3호
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• pp.144-149
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• 2010

Purpose: The aim of this case report is to present the successful clinical treatment of two cases of postoperative infection following maxillary sinus augmentation. Methods: In the two cases of postoperative infection, immediate total removal of the grafted material from the sinus was conducted to stop the spread of the infection, after which a high dose of antibiotics was administrated. Re-augmentation procedures were then conducted after the infection subsided. Results: No further complications occurred after sinus re-augmentation. The dental implants placed in the re-augmented sinus were clinically osseointegrated, and the implant-supported restorations in the two cases of postoperative infection have been functioning very well for over 2 years. Conclusions: In the case of infection of the grafted sinuses, it is necessary to completely remove the graft materials and then administer a high dose of antibiotics to treat the acute infection, after which sinus re-augmentation is suggested.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제29권3호
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• pp.206-210
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• 2007

This study observed the frequency of post-surgical infection according to post-surgical application of antibiotics in order to evaluate the benefits of the use of antibiotics after the orthognathic surgery. 349 patients without any specific medical history were divided into two groups depending on whether or not antibiotics had been applied after the surgery. The mean(SD) age of the 349 patients was 22.7(${\pm}4.25$) with a male-female ratio of 168:181. 226 patients received only 1.0g of a third-generation cephalosporin(Cefpiramide) intravenously 30 minutes prior to the surgery. Likewise, 123 patients received 1.0g of Cefpiramide 30 minutes prior to the surgery and twice daily longer than the third day after surgery. The mean(SD) duration of administration was 4.75(${\pm}0.89$) day. The patients were evaluated after surgery for any postoperative infections according to the criteria: purulent drainage from a wound, spontaneous wound dehiscence accompanied by swelling, pain, and fever around the wound. However, 14 patients of 226 patients received antibiotics only prior to the surgery developed postoperative infection, 2 patients of 123 patients received antibiotics longer than postoperative 3 days developed postoperative infection. Postoperative infection frequency showed no significant difference between the two groups(p=0.094). Also, bi-maxillary operation and mandibular operation alone, showed no significant difference in the frequency of post-surgical infection when antibiotics had been continuously used after the surgery. From this study, postoperative use of antibiotics seems to be unnecessary with view of the little significance of the factors that could affect the wound infection.

• Journal of Korean Neurosurgical Society
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• 제37권1호
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• pp.44-47
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• 2005

Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

• Journal of Korean Neurosurgical Society
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• 제38권3호
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• pp.206-210
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• 2005

Objective : Our aim is to evaluate the early changes of biologic markers such as white blood cell[WBC] count, erythrocyte sedimentation rate[ESR] and C-reactive protein[CRP] in early diagnosis of postoperative infection and to differentiate infection from inflammatory reaction in lumbar spine surgery. Methods : We reviewed 330patients who had undergone spinal operations between May 1999 and October 2001. For this study, the patients were classified into two groups, which include a group that underwent spinal decompressive surgery without instrumentation[SD], and the other group that underwent fusion surgery with spinal instrumentation[SI]. And each group was also subdivided into two groups respectively, one with infection and the other without infection. We retrospectively analyzed the WBC count, ESR and CRP preoperatively and postoperatively, according to their operation type and postoperative infection history. Results : Inflammatory indices were physiologically affected by instrumentation itself. But ESR and CRP elevations were more prolonged and sustained under infection. In SD patients without infection, ESR and CRP were stabilized 5 days after surgery. In SI patients without infection, CRP was stabilized about 7days after surgery, but ESR showed sustained and variously elevated. In both SD and SI groups, the stabilization of CRP was the most reliable behavior of surgery without infection. Conclusion : C-reactive protein is most sensitive parameter for postoperative spine infection. The knowledge of the inflammatory indices and their relatively uniform patterns with or without infection offers surgeons the ability to infer the state of surgical wound.

• Journal of Chest Surgery
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• 제3권1호
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• pp.3-12
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• 1970

During the last 10 years of period, one hundred patients with various pulmonary diseases were pneumonectomized upon at the Department of Chest Surgery of Pusan University Hospital. This paper is concerned with the clnical results of these patients along with the serious postoperative complications such as postoperative intrapleural infection and hemorrhage. The results were obtained as follows. 1.Left pneumonectomy was done in sixty-six of 100 patients [66 %] and the right one was done in the rest thirty-four[34 %]. The ratio between left and right was nearly 2:1. 2.Of all oostoperative complications, the intrapleural infection was most common, and these were 53 % in empyema thoracis and 12.7 % in pulmonary tuberculosis respectively. 3.More postoperative complications could be seen after right pneumonectomy than the left one. 4.It was thought that the postoperative intrapleural infection was closely correlated with the methods of pleural dissection at pneumonectomy,postoperatlve tube drainage, time of operation, massive hemorrhage during operation, prolongation of bleeding time, and dysfunction of the liver. 5.The repeated thoracenteses with infusion of neomycin into the infected thoracic cavity and intravenous administrations of the high units of penicillin were effective in treatment of the postoperative intrapleural infection, however, the refractory cases have to be cured by thoracoplasty with open window. 6.Immediate secondary open thoracotomy appears to be the method of choice in life saving who developed massive intrathoracic hemorrhage after pneumonectomy. 7.The mortality rate was 10 % in our cases and the main causes of death were postoperative respiratory insufficiency, pulmonary edema, hemorrhage and sudden cardiac arrest.

• 대한장애인치과학회지
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• 제8권2호
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• pp.134-138
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• 2012

In treatment of dentigerous cyst, complete enucleation, histopathologic examination and postoperative care are important to prevent the potential complications (mural ameloblastoma, squamous cell carcinoma). On the other hand, a maxillary impacted supernumerary anterior tooth are removed surgically, owing to the possibility of the cyst formation in future. After the cyst enucleation and extraction of the involved tooth, the wound area sutured and removable resin plate is then applied. In this operation, the postoperative bleeding and infection is likely to occur owing to postoperative accumulation of hematoma & seroma, psychologic stress and other contaminated factor. So, the authors established the immediate rubber & iodoform gauze drainage into the sutured wound of cyst enucleation & tooth extraction for the prevention of postoperative bleeding and infection. The removable resin splint are not used because of the poor cooperation and economic factor. The results were more favorable without the postoperative bleeding & wound infection in a cerebral palsy patient.

• Journal of Korean Neurosurgical Society
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• 제47권4호
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• pp.265-270
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• 2010

Objective : The purpose of this study is to identify the relationship between asymptomatic urinary tract infection (aUTI) and postoperative spine infection. Methods : A retrospective review was done in 355 women more than 65 years old who had undergone laminectomy and/or discectomy, and spinal fusion, between January 2004 and December 2008. Previously postulated risk factors (i.e., instrumentation, diabetes, prior corticosteroid therapy, previous spinal surgery, and smoking) were investigated. Furthermore, we added aUTI that was not previously considered. Results : Among 355 patients, 42 met the criteria for aUTI (Bacteriuria ${\geq}\;10^5\;CFU/mL$ and no associated symptoms). A postoperative spine infection was evident in 15 of 355 patients. Of the previously described risk factors, multi-levels (p<0.05), instrumentation (p<0.05) and diabetes (p<0.05) were proven risk factors, whereas aUTI (p>0.05) was not statistically significant. However, aUTI with Foley catheterization was statistically significant when Foley catheterization was added as a variable to the all existing risk factors. Conclusion : aUTI is not rare in elderly women admitted to the hospital for lumbar spine surgery. The results of this study suggest that aUTI with Foley catheterization may be considered a risk factor for postoperative spine infection in elderly women. Therefore, we would consider treating aUTI before operating on elderly women who will need Foley catheterization.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.255-260
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• 2022

Purpose: To determine the incidence and risk factors of postoperative infection after cranioplasty in patients with traumatic brain injury (TBI). Methods: Data of 289 adult patients who underwent cranioplasty after TBI at a single regional trauma center between year 2018 and 2021 were reviewed retrospectively. Patient characteristics and various procedural variables, such as interval between craniectomy and cranioplasty, estimated blood loss, laterality and materials of the bone flap, and duration and classification of perioperative antibiotics usage were analyzed. Results: Postoperative infection occurred in 17 patients (5.9%). Onset time of infectious symptom ranged from 9 days to 174 days (median, 24 days) after cranioplasty. The most common cultured organism was Staphylococcus aureus (47.1%), followed by Klebsiella pneumoniae (17.6%) and Enterococcus faecalis (17.6%). Patients with postoperative infection were more likely to have diabetes (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.92-25.21; P=0.003), lower body mass index (OR, 0.81; 95% CI, 0.66-0.98; P=0.029), and shorter duration of perioperative antibiotics (OR, 0.83; 95% CI, 0.71-0.98; P=0.026). Conclusions: For TBI patients with diabetes, poor nutritional status should be managed cautiously for increased risk of infection after cranioplasty. Further studies and discussions are needed to determine an appropriate antibiotics protocol in cranioplasty.