Postoperative antibiotic prophylaxis in mandibular fractures: A preliminary randomized, double-blind, and placebo-controlled clinical study.

PURPOSE: This study evaluated the difference between the effect of a 5-day postoperative course of oral antibiotics and a placebo on the incidence of postoperative infection in uncomplicated fractures of the mandible. PATIENTS AND METHODS: A prospective, randomized, double-blind clinical study using a placebo control was carried out. Thirty patients were randomly assigned into 2 groups: group 1 (14 patients) and group 2 (16 patients). Each group received penicillin G, 2 million U intravenously, every 4 hours through the preoperative period, intraoperative period, and for 12 hours postoperatively. Group 1 then received penicillin VK, 500 mg every 6 hours for 5 days. Group 2 received oral placebo using the same schedule for the same duration as group 1. The patients were than evaluated for evidence of infection 1, 2, 4, and 6 weeks postoperatively. RESULTS: Two of 14 patients in group 1 (14.3%) and 2 of 16 patients in group 2 (12.5%) developed infections. No statistically significant difference in the incidence of infection was noted between the groups. CONCLUSIONS: In this preliminary study, the use of postoperative oral antibiotics in uncomplicated fractures of the mandible had no benefit in reducing the incidence of infections.

Telemedicine consultations in oral and maxillofacial surgery.

PURPOSE: The purpose of this study was to evaluate the efficiency of telemedicine consultation for preoperative assessment of patients. PATIENTS AND METHODS: A retrospective study of 43 patients was done to evaluate the efficiency of telemedicine consultation in adequately assessing patients for dentoalveolar surgery with general anesthesia and nasotracheal intubation. Efficiency was defined as the ability to conduct surgery with general anesthesia at the immediately following clinic appointment without the need for further preoperative testing, evaluation, or consultation. Thirty-five of these patients were subsequently treated. RESULTS: Ninety-five percent (33) of patients were able to undergo surgery with general anesthesia at the immediate appointment, and 100% of patients were assessed correctly, using telemedicine consultation. Two of the patients were assessed as American Society of Anesthesiologists Class III during telemedicine consultation and required further evaluation before surgery could be scheduled. No surgical procedure was canceled, and there were no anesthetic complications attributable to inadequate preoperative assessment of patients during telemedicine consultation. CONCLUSIONS: This study confirms that telemedicine consultations are as reliable as those conducted by traditional methods. Because of the reorganization of health care and the ways it is financed, it may be more economical to move data from place to place than to move doctors from place to place. Telecommunication is an efficient and cost-effective mechanism to provide preoperative evaluation in situations in which patient transport is difficult or costly.