Relative blood loss and operative time can predict length of stay following orthognathic surgery

Andersen, Karen V; Thastum, Mille Moeller; Nørholt, Sven Erik; Blomlöf, Johan

doi:10.1016/j.ijom.2016.05.015

Cited by 28 publications

(21 citation statements)

References 11 publications

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“…Great variability is seen in operating time in the recent literature. 14,15,[18][19][20] The present finding contradicts those of previous studies that have reported longer durations for piezoelectric osteotomy. 15 However, no information is available in these studies on the experience of performing piezoelectric osteotomy by the participating surgeons.…”

Section: Discussioncontrasting

confidence: 94%

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation

Köhnke

Kolk

Ploder

2017

Journal of Oral and Maxillofacial Surgery

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Section: Discussioncontrasting

confidence: 94%

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation

Köhnke

Kolk

Ploder

2017

Journal of Oral and Maxillofacial Surgery

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“…The results of our study showed that the patients who were operated on with only an HOSO without additional procedures had a significant reduction in OP-time and that the time was reduced over the years (P < 0.0015). This is of importance because a lower intraoperative time is correlated with lower blood loss and fewer complications [13,14].…”

Section: Discussionmentioning

confidence: 99%

Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article)

et al. 2020

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Background The high-oblique sagittal osteotomy (HOSO) is an alternative to a bilateral sagittal split osteotomy (BSSO). Due to its novelty, there are no long-term studies which have focused on describing the incidence and type of complications encountered in the post-operative follow-up. The aim of this retrospective study is to analyze patients operated on with this surgical technique and the post-operative complications encountered. Patient and methods The electronic medical records of all patients treated with orthognathic surgery at the Department of Oral, Maxillofacial and Facial Plastic Surgery, University Hospital Frankfurt, Goethe University, Frankfurt, Germany, between the years 2009 and 2016 were retrospectively reviewed. Results A total of 116 patients fulfilled the inclusion criteria. The cases operated on with the standard osteosynthesis (X, Y, and straight) showed a complication rate of 36.37% (n = 4/11). The cases operated on with the HOSO-dedicated plates (HOSO-DP) showed, in total, a complication rate of 6.67% (n = 7/105). The most common post-operative complication resulting from both fixation methods was a reduction in mouth opening and TMJ pain for 4.3%. During the first years of performing the surgery (2009–211), a variety of standard plates had material failure causing non-union or pseudarthrosis. No cases of material failure were observed in the cases operated on with the HOSO-DP. The statistical results showed a highly significant dependence of a reduction in OP-time over the years, when the HOSO was performed without additional procedures (R2 > 0.83, P < 0.0015). Conclusion The rate of complications in the HOSO were shown to be comparable to the rate of complications from the BSSO reported in the literature. Moreover, the use of the ramus dedicated plate appears to provide enough stability to the bone segments, making the surgery safer. Clinical relevance The HOSO needs to be considered by surgeons as an alternative to BSSO. Once the use of the HOSO-DP was established, the rate of complications and the operation time reduced considerably.

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“…Our finding that extended operative time increased the risk of perioperative complications is consistent with prior studies. [52][53][54][55] Longer operative time allows for the potential for increased intraoperative blood loss, which may contribute to the increased risk of intra-or postoperative blood transfusion. Of note, high intraoperative blood loss >500 mL in instrumented spinal fusion procedures has been shown to be associated with increased risk of surgical site infections.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

Ranson

Cheung

Capua

et al. 2018

Global Spine Journal

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Study Design:Retrospective cohort study.Objectives:The prevalence of obesity-related low back pain and degenerative disc disease is on the rise. Past studies have demonstrated that obesity is associated with higher perioperative complication rates, but there remains a gap in the literature regarding additional risk factors that further predispose this already high-risk patient population to poor surgical outcomes following elective posterior lumbar fusion (PLF). The aim of the study is to identify independent risk factors for poor 30-day perioperative outcomes in morbidly obese patients undergoing elective PLF.Methods:We identified 22 909 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent elective PLF. There were 1861 morbidly obese patients. Baseline patient demographics and medical comorbidities were collected. Univariate analysis was performed to compare perioperative complication rates between non-morbidly obese and morbidly obese patients. The 5 most common complications in the morbidly obese group were then selected for multivariate regression analysis to identify independent risk factors for poor 30-day outcomes.Results:Morbidly obese patients had a higher perioperative complication rate. The 5 most common complications were prolonged hospitalization, blood transfusion, readmission, wound complications, and reoperation. Independent risk factors for these complications were age ≥65 years, super obesity (ie, BMI > 48.6), chronic steroid use, American Society of Anesthesiology classification ≥3, poor functional status, long length of fusion ≥4 levels, and extended operative time (ie, operative time ≥318 minutes).Conclusions:Morbidly obese patients are at higher risk of perioperative complications following elective PLF. Modifiable risk factors for the most common complications are obesity and preoperative steroid use.

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Relative blood loss and operative time can predict length of stay following orthognathic surgery

Cited by 28 publications

References 11 publications

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation

Piezosurgery for Sagittal Split Osteotomy: Procedure Duration and Postoperative Sensory Perturbation

Revision of 116 orthognathic surgery patients operated on with the high-oblique sagittal osteotomy (HOSO): a retrospective case series (PROCESS-compliant article)

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

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