Feasibility of outpatient management of mandibular fractures: a pilot study

Background : Over 300 mandibular fractures are managed in this department annually. Currently, all surgery is performed as inpatient care. On occasion, the operation occurs in the day surgery unit (DSU), although the patient remains as an inpatient. There is a shortage of inpatient beds and a proportion of mandibular fractures could theoretically be managed as outpatient care. A rapid access service exists for operations to be carried out by other specialties in this manner.

Aims : To determine the feasibility of providing an outpatient service for the management of mandibular fractures To evaluate potential cost and inpatient bed reductions.

Methods : A prospective study of patients admitted with mandibular fractures. Patients were excluded if under 16 y or had other indications for admission/surgery. Data collection included: time from injury to surgery, anaesthetic duration, mandibular injury severity score (MISS), operative details and medical/socio-domestic history. Post-operative recovery was assessed at 2, 3 and 5 h as per the DSU criteria for discharge (pain, vital signs, wound site, and other physiological parameters).

Results (ongoing) : • 30 cases, 22 male, mean age 30 y. • Patients waited from 0 to 8 days from injury to surgery (mean 2.5 d). • Mean anaesthetic duration was 144 min (40–285 min). • 85% of patients met the criteria for DSU admission. • 57% of patients were recovered to being appropriate for discharge at 5 h post op. as per DSU criteria.

Conclusion : A significant number of cases would have been appropriate for outpatient management. The study continues to gather more evidence for the selection and prediction of these cases. Key words : mandible fracture; day surgery

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Jan 20, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Feasibility of outpatient management of mandibular fractures: a pilot study
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