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Published in: Journal of Maxillofacial and Oral Surgery 1/2021

01-03-2021 | Original Article

Evaluation of the Variations in the Levels of Perioperative Inflammatory Markers After Open Reduction and Internal Fixation of Maxillofacial Fractures

Authors: Parveen Sharma, Rishi Kumar Bali, Avneet Kaur, Shivani Gaba, Guneet Dhillon

Published in: Journal of Maxillofacial and Oral Surgery | Issue 1/2021

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Abstract

Introduction

Postoperative infectious complications are commonly encountered in open reduction and internal fixation (ORIF) of maxillofacial fractures. An early diagnosis of infectious processes is the key in preventing morbidity/mortality which could be in the form of loss of hardware and sepsis. To prevent these, various markers of inflammation have been studied in different disciplines of surgery but are found scarce in maxillofacial practice.

Material and method

The present study was designed to evaluate the perioperative variations in the levels of inflammatory markers. We analysed temperature, TLC, DLC, ALT, AST and CRP in 50 patients of ORIF. Their values were recorded preoperatively as well as at 24 h, 48 h, third day and seventh day postoperatively. The correlation of inflammatory markers with the type of anaesthesia and length of surgery were also analysed.

Results

The ranges of various markers in the perioperative phase were: temperature (97.6 ºF–99.2 ºF), TLC (5100/mm3–18200/mm3), neutrophils (51–91%), AST (12–86 IU/L), ALT (12–96 IU/L) and CRP (1.2–150 mg/L). Mean values of all the inflammatory markers achieved their peak values within 24 h postoperatively. These values showed a decline thereafter, with the day 3 and day 7 values being even lower than their preoperative values. This fall in the values was highly significant (p < 0.001) except ALT where the fall was significant (p < 0.05). The data obtained could be used as a reference range by the surgeons for monitoring the recovery of the patient. It could also help in timely interception and expeditious management of an infectious episode in the postoperative phase.
Literature
1.
go back to reference Colley CM, Feleck A, Goode AW, Muller BR, Myers MA (1983) Early time course of the acute phase protein response in man. J Clin Pathol 36:203–207CrossRef Colley CM, Feleck A, Goode AW, Muller BR, Myers MA (1983) Early time course of the acute phase protein response in man. J Clin Pathol 36:203–207CrossRef
2.
go back to reference Aono H, Ohwada T, Kaneko N, Fuji T, Iwasaki M (2007) The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion. J Bone Jt Surg 89(11):1478–1481CrossRef Aono H, Ohwada T, Kaneko N, Fuji T, Iwasaki M (2007) The post-operative changes in the level of inflammatory markers after posterior lumbar interbody fusion. J Bone Jt Surg 89(11):1478–1481CrossRef
3.
go back to reference Neumaier M, Scherer MA (2008) C-reactive protein levels for early detection of postoperative infection after fracture surgery in 787 patients. Acta Orthop 79(6):428–432CrossRef Neumaier M, Scherer MA (2008) C-reactive protein levels for early detection of postoperative infection after fracture surgery in 787 patients. Acta Orthop 79(6):428–432CrossRef
4.
go back to reference Niskanen RO, Korkala O, Pammo O (1996) Serum C-reactive protein after total hip and knee arthroplasty. J Bone Jt Surg 78-B:431–433CrossRef Niskanen RO, Korkala O, Pammo O (1996) Serum C-reactive protein after total hip and knee arthroplasty. J Bone Jt Surg 78-B:431–433CrossRef
5.
go back to reference Durila M, Bronsky J, Harustiak T, Pazdro A, Pechova M, Cvachovec K (2012) Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography). BMC Anaesthesiol 12:12CrossRef Durila M, Bronsky J, Harustiak T, Pazdro A, Pechova M, Cvachovec K (2012) Early diagnostic markers of sepsis after oesophagectomy (including thromboelastography). BMC Anaesthesiol 12:12CrossRef
6.
go back to reference Giannoudis PV, Smith RM, Banks RE, Windsor AC, Dickson RA, Guillou PJ (1998) Stimulation of inflammatory response after blunt trauma. Br J Surg 85(7):986–990CrossRef Giannoudis PV, Smith RM, Banks RE, Windsor AC, Dickson RA, Guillou PJ (1998) Stimulation of inflammatory response after blunt trauma. Br J Surg 85(7):986–990CrossRef
7.
go back to reference Hussain M, Kim H (2002) C-reative protein and erythrocyte sedimentation rate in orthopaedics. Univ Penn Orthop J 15:13–16 Hussain M, Kim H (2002) C-reative protein and erythrocyte sedimentation rate in orthopaedics. Univ Penn Orthop J 15:13–16
8.
go back to reference Abtullah M, Olzem K, Polat G, Baddatodlu C, Colak M, Kuyuratar F (2004) Acute phase proteins after orthopaedic surgery. Clin Res 15:85–89 Abtullah M, Olzem K, Polat G, Baddatodlu C, Colak M, Kuyuratar F (2004) Acute phase proteins after orthopaedic surgery. Clin Res 15:85–89
9.
go back to reference Aminzadeh A, Parsa E (2011) Relationship between age and peripheral white blood cell count in patients with sepsis. Int J Prev Med 2(4):238–242PubMedPubMedCentral Aminzadeh A, Parsa E (2011) Relationship between age and peripheral white blood cell count in patients with sepsis. Int J Prev Med 2(4):238–242PubMedPubMedCentral
10.
go back to reference Santucci A, Purcell T, Mejia C (2008) Leukocytosis as a predictor of severe injury in blunt trauma. West J Emerg Med 9(2):81–85PubMedPubMedCentral Santucci A, Purcell T, Mejia C (2008) Leukocytosis as a predictor of severe injury in blunt trauma. West J Emerg Med 9(2):81–85PubMedPubMedCentral
12.
go back to reference Deodhar SD (1989) C-reactive protein: the best laboratory indicator available for monitoring disease activity. Clevel Clin J Med 56(2):126–130CrossRef Deodhar SD (1989) C-reactive protein: the best laboratory indicator available for monitoring disease activity. Clevel Clin J Med 56(2):126–130CrossRef
13.
go back to reference Fischer CL, Gill CW (1975) Acute-phase proteins. In: Ritzmann SE, Daniels JC (eds) Serum protein abnormalities: diagnostic and clinical aspects. Little, Brown and Co., Boston, pp 331–350 Fischer CL, Gill CW (1975) Acute-phase proteins. In: Ritzmann SE, Daniels JC (eds) Serum protein abnormalities: diagnostic and clinical aspects. Little, Brown and Co., Boston, pp 331–350
14.
go back to reference Morley JJ, Kushner I (1982) Serum C-reactive protein levels in disease. Ann N Y Acad Sci 389:406–417CrossRef Morley JJ, Kushner I (1982) Serum C-reactive protein levels in disease. Ann N Y Acad Sci 389:406–417CrossRef
16.
go back to reference Barreto VT, Isaac A, Bhimidi P, Nguyen C, Jones G (2013) Trends of C-reactive protein laboratory values with white blood cell count levels in maxillofacial infections. Anesth Infect Pathol Med 71:e31 Barreto VT, Isaac A, Bhimidi P, Nguyen C, Jones G (2013) Trends of C-reactive protein laboratory values with white blood cell count levels in maxillofacial infections. Anesth Infect Pathol Med 71:e31
17.
go back to reference Kiran DN, Rajendra D (2012) Estimation of CRP associated with mandibular fracture. J Maxillofac Oral Surg 11(1):67–71CrossRef Kiran DN, Rajendra D (2012) Estimation of CRP associated with mandibular fracture. J Maxillofac Oral Surg 11(1):67–71CrossRef
18.
go back to reference Gwak JM, Kim CH, Kim KW (2006) The changes of c-reactive prothin in the patients associated with mandibular fracture. Korean Assoc Maxillofac Plast Reconstr Surg 28(1):35–41 Gwak JM, Kim CH, Kim KW (2006) The changes of c-reactive prothin in the patients associated with mandibular fracture. Korean Assoc Maxillofac Plast Reconstr Surg 28(1):35–41
19.
go back to reference Gupta R, Singh R, Soni M (2002) C-reactive protein as an indicator of sepsis in orthopaedic trauma. Indian J Med Sci 56(10):501–507PubMed Gupta R, Singh R, Soni M (2002) C-reactive protein as an indicator of sepsis in orthopaedic trauma. Indian J Med Sci 56(10):501–507PubMed
20.
go back to reference Aalto K, Osterman K, Peltola H, Rasanen J (1984) Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty. Clin Orthop Relat Res 184:118–120 Aalto K, Osterman K, Peltola H, Rasanen J (1984) Changes in erythrocyte sedimentation rate and C-reactive protein after total hip arthroplasty. Clin Orthop Relat Res 184:118–120
21.
go back to reference Larsson S, Thelander U, Friberg S (1992) C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res 275:237–242 Larsson S, Thelander U, Friberg S (1992) C-reactive protein (CRP) levels after elective orthopedic surgery. Clin Orthop Relat Res 275:237–242
Metadata
Title
Evaluation of the Variations in the Levels of Perioperative Inflammatory Markers After Open Reduction and Internal Fixation of Maxillofacial Fractures
Authors
Parveen Sharma
Rishi Kumar Bali
Avneet Kaur
Shivani Gaba
Guneet Dhillon
Publication date
01-03-2021
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery / Issue 1/2021
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-018-1174-4

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