Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery.

Introduction: The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice. Materials and Methods: The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates. Results: At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations. Conclusion: Risk of sharps injury was relatively high due to the high incidence of glove perforation.

Pattern of maxillofacial surgical conditions in North Central Nigeria: A 5-year experience of an indigenous surgical mission.

BACKGROUND: Several publications have presented pattern of maxillofacial surgical conditions based on data from hospital-based studies. The objective of this study is to present the spectrum of maxillofacial surgical conditions from the perspective of a community study. METHODS: This is a prospective study of all patients seen and treated from 2011 to 2016. The information obtained included the biodata, clinical history of the disease conditions, radiological result, histopathologic result, diagnosis, and treatment records. Data analysis was carried out using SPSS version 20.0. RESULTS: There was a total of 863 patients, male 464 (53.8%) and female 399 (46.2%). The male to female sex ratio was 1.16:1. The age range was 3 days to 76 years with a mean age (SD) 16.8 ± 15.8 years. The spectrum of surgical conditions: facial clefts 492(57.0%); tumor and tumor-like lesions 126(15.2%), trauma 6(0.7%), and others 48(5.5 %). The size of tumors ranged from 5 to 50.4 cm2 with a mean (SD) 21.6 ± 11.9 cm2 and the duration of lesion ranged from 1 to 20 years with mean (SD) 8.7 ± 6.0 years. A total of 622(77.4) cases were operated within the study period with immediate jaw reconstruction in 5(0.8%) patients. Minor complications were recorded but there was no mortality. CONCLUSION: The spectrum of maxillofacial surgery from community-based data was associated with higher percentage of facial cleft as compared to hospital-based study that is associated with higher traumatic injury cases. High level of poverty, ignorance, and poor access to maxillofacial service have been identified as shortcomings in the management of the diseases. There is a need for pragmatic move to improve facility, training, enlightenment, and more funding of outreach programs.

Concomitant injuries associated with maxillofacial fractures in Abuja, Nigeria.

BACKGROUND: Injury is the leading cause of death and disability and the third most common cause of death Little attention has been given to the concomitant injuries associated with maxillofacial fractures in scientific literatures. OBJECTIVES: For effective planning and efficient management of the patients, there is need to study the pattern ofthese injuries. METHODS: Consecutive patients who sustained one or more facial bone fractures over a period of 2 years were prospectively studied. RESULTS: There were 103 patients out of which 96 sustained concomitant injuries giving an incidence of 93.2%.There were 75 (78.1%) males and 21 (21.9%) females with a M:F of 3.6:1. The mean + (SD) age was 30.8 +13.0 with a range of 2.0 to 68.0 years. Road Traffic Crashes was the commonest (n = 81, 84.4%) cause of injury. Soft tissue of the face, with an incidence of 62.1% (n = 64) was the commonest concomitant injury. It was followed by neurologic injury (n = 51, 49.5%) and ophthalmic injury (n = 38, 36.9%) while abdominal injury (n = 2, 1.9%) was the least common. Majority (87.5%) of the ophthalmic injury patients sustained midfacial fracture while 12.5% of the them sustained mandibular fractures. Pulmonary and cervical injuries were found to be associated more with mandibularfractures. CONCLUSION: Concomitant injuries occur commonly with maxillofacial fractures and they were found to have significant effect on the management of the fractures. A multidisciplinary approach will bring about a very efficient management of patients.