Prevalence of postoperative secondary bleeding and its relationship with intraoperative massive bleeding in patients undergoing orthognathic surgery.

INTRODUCTION: Postoperative bleeding after orthognathic surgery is a rare but life-threatening complication. Maxillary surgery is the main cause of bleeding, after which excessive epistaxis can occur until the 10th postoperative day. Due to the risk of secondary bleeding, the patient discharge process may be complicated for both the patient and clinician. Thus far, no studies have explored massive intra- and postoperative bleeding in patients undergoing orthognathic surgery. Therefore, this study was performed to determine the prevalence of postoperative secondary bleeding and its correlation with intraoperative massive bleeding in patients undergoing orthognathic surgery. MATERIALS AND METHODS: A total of 206 orthognathic surgery patients were included in this retrospective study. Perioperative data was collected by determining the number of patients who referred to the clinic for treatment of secondary bleeding. The following parameters were recorded: occurrence of intraoperative massive bleeding, pre- and postoperative haemoglobin and haematocrit values, intraoperative projected bleeding, amount of intravenous liquid needed, and length of hospital stay. In addition, the association between secondary and intraoperative massive bleeding was investigated. RESULTS: Two of 206 patients (0.97%) experienced both massive intraoperative bleeding and massive postoperative bleeding. CONCLUSION: Intra- and postoperative massive bleeding occurred only in a small number of patients; thus, longer hospitalisation and strict follow-up of this small group of patients may be required.

Effects of different mandibular fracture patterns on the stability of miniplate screw fixation in angle mandibular fractures.

The aim of the present study was to evaluate the effects of horizontally favourable and unfavourable mandibular fracture patterns on the fixation stability of titanium plates and screws by simulating chewing forces. Favourable and unfavourable mandibular fractures on 22 sheep hemimandibles were fixed with 4-hole straight titanium plates and 2.0mm×7mm titanium screws according to the Champy technique. Hemimandibles were mounted with a fixation device in a servohydraulic testing unit for compressive testing. Displacement values under 20, 60, 100, 120, 150, 200N, maximum displacements, and maximum forces the model could resist before breakage were recorded and compared. The authors found no statistically significant differences between the groups for the displacement values in the force range 60-200N (60, 100, 120, 150 and 200N). Statistically significant differences for maximum displacement values (displacement values at the breaking forces) between the groups were found (P<0.05). There was no evidence for the need to apply different treatment modalities to mandibular fractures regardless of whether the factures are favourable or not.