Efficacy of Silicone Gel in Healing of Lacerated Wounds in Maxillofacial Region-An Experimental Study.

Background: Face plays the most crucial part in defining personality and anything that hampers the facial esthetics foists a great amount of psychological impact. Hence, it is extremely important to manage the facial injuries efficiently and consider all the three elements of recovery, i.e., psychological, medical and esthetics. Purpose-To evaluate the efficacy of silicone gel in healing of lacerated wounds on face. Materials and methods: A sample size of 44 patients in each group undergoing suturing of contused lacerated wound (CLW) was calculated with P-67, q-52 and l-10 Using Formula, N = 4pq/l2 using Statistical Package for Social Sciences (SPSS) software version 23. Patients were divided into two groups, Group A and Group B where Group A was study group who applied silicone over sutured wounds, while Group B was control group who did not applied any gel. Results: In silicone group, a significant difference was observed between 7th day and 30th, 60th, 90th and 120th day in healing scores, while in non-silicone group, no significant difference was observed at the initial period. However, difference started to appear from 90th day and continued till 120th day. Conclusion: Silicone gel has considerable effect in healing of wound and prevention of unesthetic scarring when it is applied immediately from the day of suture removal and continued till 3 months.

ATOM technique: Anatomic reduction using screw-wire Traction for Open reduction and internal fixation of Mandibular fractures.

Various techniques are well documented to obtain anatomic reduction, such as reduction forceps, manual reduction, or a combination of these methods. However, these techniques have inherent drawbacks. We propose a new intra-operative technique for anatomic reduction using screw-wire traction for open reduction and internal fixation of mandibular fractures.

Infra-orbital nerve block using alar base approach: A novel landmark and technique.

The infra-orbital nerve block is given to anaesthetize the anterior part of maxilla by depositing the local anesthetic agent in proximity of the infra-orbital nerve foramen. The two intra-oral approaches well documented in the literature are the 'central incisor approach' or the 'bicuspid approach'. In 2011, Infra-orbital nerve block with extended coverage using the intra-oral 'molar approach' was employed. However, infra-orbital nerve block can pose a challenge in patients with no teeth. We have devised a novel landmark and technique for infra-orbital nerve block using the anatomical landmark alar base.

Three-dimensional Locking Plate and Conventional Miniplates in the Treatment of Mandibular Anterior Fractures.

CONTEXT: Three-dimensional (3D) locking plates has been designed with the hypothesis that this will overcome the disadvantages of both the systems and also advantages of both systems will be combined for the management of mandibular fractures. AIMS: The purpose of this study was to evaluate the efficacy of 2-mm 3D locking miniplate in the management of anterior mandibular fracture and to compare it with Champy's miniplate. SETTINGS AND DESIGN: A prospective, randomized, clinical trial was carried out in thirty patients who were divided equally in two groups. SUBJECTS AND METHODS: Group I and Group II patients were treated with 2-mm 3D locking plates and 2-mm standard miniplates, respectively. They were evaluated according to the outcomes of the study, that is, working time, wound dehiscence, infection, segmental mobility, postoperative occlusion, need for postoperative intermaxillary fixation (IMF), and radiological evaluation of reduction and fixation. STATISTICAL ANALYSIS USED: Student's t-test and Mann-Whitney test were used to compare the two systems. The data were analyzed using Statistical Package for the Social Science version 14.0. The P value was taken as significant when <0.05 (confidence interval of 95% was taken). RESULTS: The mean duration of procedure for Group I was found to be 49.33 min, whereas for Group II was 59.67 min. There was significantly greater pain on day 1 and at 1 week in Group II patients. 6.7% (n = 1) of both groups showed incidence of infection. Postoperative stability was adequate in most cases except in one patient (n = 1) of 3D locking system, which was revealed as postoperative occlusal disharmony, unsatisfactory radiological reduction of the fracture fragments, and the segmental mobility. There was no incidence of wound dehiscence, tooth damage, and nerve damage in either group. CONCLUSIONS: The result of the study can conclude that there is no major difference between both systems in terms of treatment outcome.

Comparison of intermaxillary fixation screw versus eyelet interdental wiring for intermaxillary fixation in minimally displaced mandibular fracture: a randomized clinical study.

PURPOSE: The aim of the present randomized study was to evaluate the efficacy of intermaxillary fixation screw (IMFS) versus eyelet interdental wiring for intermaxillary fixation (IMF) in minimally displaced mandibular fractures. MATERIALS AND METHODS: A total of 50 patients with a minimally displaced mandibular fracture were enrolled, with 25 patients randomly selected for each group. In group I (study group, n = 25), the patients were treated using IMFS, and in group II (control group, n = 25), they received eyelet interdental wiring. Both techniques were assessed for the following parameters: time required for placement and removal of each type of IMF technique, time required for placement of IMF wires, postoperative occlusion, stability of the IMF wire, local anesthesia requirement during removal of each fixation type, oral hygiene status, glove perforation rate, and complications associated with both techniques. The collected data were analyzed using Student's unpaired t test or χ2 test. P < .05 was considered significant and the Statistical Package for Social Sciences software, version 10, was used for analysis. RESULTS: The average time required for placement in groups I and II was 17.56 and 35.08 minutes, respectively (P = .000). The time required for placement of the IMF wire in group I was 2.1 minutes and in group II was 6 minutes. The oral hygiene status was assessed, and the mean plaque index score for groups I and II was 1.44 and 2.12, respectively (P = .00). The glove perforation rate was much less in group I than in group II. Finally, the most common complication in both groups was mucosal growth. CONCLUSIONS: The results established the supremacy of IMFS compared with eyelet interdental wiring. Thus, we have concluded that IMFS, in the present scenario, is a safe and time-saving technique. IMFS is a cost-effective, straightforward, and viable alternative to cumbersome eyelet interdental and other wiring techniques for providing IMF, with satisfactory occlusion during closed reduction or intraoperative open reduction internal fixation of fractures. In addition, oral hygiene can be maintained, and the glove perforation rate was very low using IMFS. The relatively small sample size and limited follow-up period were the study limitations.

Transmylohyoid orotracheal intubation: case series and review.

STUDY OBJECTIVE: To evaluate the outcome of airway management in patients with complex maxillofacial fracture by submental intubation, time required for intubation, accidental extubation, and postoperative complications. DESIGN: Retrospective study. SETTING: University-affiliated hospital. MEASUREMENTS: The medical records of the 10 patients who underwent submental intubation from December 2008 to June 2011 were reviewed. MAIN RESULTS: At the end of the procedure, all 10 patients were extubated without any complications. Postoperatively, only one patient presented with superficial infection of the submental wound. CONCLUSIONS: Submental endotracheal intubation is a simple technique with very low morbidity, and may be used as an alternative to tracheostomy in selected cases of maxillofacial trauma.

Submental orotracheal intubation: Our experience and review.

INTRODUCTION: In maxillofacial injuries, a choice has often to be made between different ways of intubation when surgical access to fractured nasal bone and simultaneous establishment of occlusion are required. We report our experience with submental intubation in the airway management of complex maxillofacial trauma patients. AIMS: To evaluate the outcome of airway management in patients with complex maxillofacial fracture by submental intubation, time required for intubation, accidental extubation, postoperative complications, and to discuss indications, contraindications, advantages and disadvantages of submental intubation. SETTINGS AND DESIGN: A retrospective study is designed. MATERIALS AND METHODS: The medical records of seven patients who underwent submental intubation from December 2008 to June 2010 were reviewed and no statistical analysis was used. RESULTS: At the end of the procedure all seven patients were extubated without any complications. Postoperatively only one patient presented with superficial infection of the submental wound. CONCLUSIONS: Submental endotracheal intubation is a simple technique with very low morbidity and can be used as an alternative to tracheostomy in selected cases of maxillofacial trauma.