Maxillofacial injury – a retrospective analysis of time lapse between injury and treatment

摘要

Background: The sooner that a maxillofacial injury is treated the lower the complicationudrate will be, and the more ideal the healing. Staff in the Division of Maxillofacial and OraludSurgery at the Charlotte Maxeke Johannesburg Academic Hospital have an anecdotal beliefudthat facial fractures are treated about three weeks after injury. An extensive search showedudthat no objective evidence on treatment times have been published in South Africa orudinternationally. The current study was undertaken to provide evidence.udObjective: To undertake a clinical audit to examine seven time intervals from fractureudoccurrence to patient discharge.udMethods: Data were recorded into a Microsoft Excel spreadsheet from the clinical recordsudof 725 patients with facial fractures in 2002, 2004 and 2006. These data were analysed usingudSAS.udResults: The broad demographics of the 725 patients were 86% male and 14% female andud79% of fractures were due to interpersonal violence. For the total sample the mean timesud±SD in days for the seven time intervals are fracture occurrence – hospital presentationud10.3±12.7, fracture occurrence – treatment 20.4±17.6, referral (n=333) – hospitaludpresentation 4.5±8.3, referral – treatment 14.6±15.6, hospital presentation – treatmentud10.3±11.8, treatment – discharge 1.3±2.0, hospital presentation – discharge 11.7±12.8.udStatistically significant effects were noted for year of study for 6/7 time intervals while thereudwere significant associations with referral and race for one time interval each.udConclusions: For this unique study no data exists for comparison. The results suggest thatudthat patients could reduce the time intervals from fracture occurrence to hospitaludpresentation and treatment by seeking definitive treatment earlier – possible reasons foruddelay are mentioned in Chapter 4. From the side of MFOS clinicians, efficient referral forudspecialist treatment and more staff could further reduce time to treatment.