Outcomes of prophylactic antibiotics following surgery for zygomatic bone fractures

Abstract

Data regarding the use of prophylactic antibiotics and infection rate following surgery for fractures of the zygomatic bone is scarce. Therefore an audit of the use and outcomes of antibiotic prophylaxis for surgery of fractures of the zygoma was undertaken. Following audit approval, four maxillofacial surgery units in the Yorkshire Region gathered prospective data for 134 patients undergoing surgery for fractures of the zygoma. Data was collected on four groups of patients undergoing surgery for fractures of the zygomatic bone: uncomplicated reductions of the zygomatic arch, reductions of the zygomatic complex without mini-plate fixation, reductions of the zygomatic complex using mini-plate fixation but excluding zygomatico-maxillary buttress, and fixation of the zygomatic complex with miniplates including the zygomatico-maxillary buttress. The choice and timing of any antibiotics given peri-operatively was recorded, and 30 days after the operation, the patients' notes were reviewed to identify any episodes of surgical site infection (SSI) requiring the prescription of antibiotics, or any instances of plate removal in the post-operative period. This data has demonstrated that the prescription of antibiotic prophylaxis for surgery for fractures of the zygomatic bone is extremely variable, and that the infection rate is low.