Comparison of wound management methods after removal of maxillofacial osseous lesions

Purpose: To evaluate outcomes associated with choice of wound management, ie, primary closure or healing by secondary intention, of osseous defects after excision of maxillofacial bone lesions as a guide to clinical practice. Patients and Methods: Using a retrospective cohort study design, we enrolled a sample composed of subjects treated for jaw lesions between 1995 and 2003. The primary predictor variable was the wound management choice of the residual jaw defect, classified as primary closure or healing by secondary intention. The primary outcome variable was postoperative inflammatory complications. Other study variables were grouped as demographic, medical/dental history, lesion information, preoperative complications, operative treatment, and follow-up information. Appropriate uni-, bi-, and multivariate statistics were computed. Results: The sample was composed of 93 subjects with 126 jaw lesions, of which 90 (71.4%) were managed by primary closure. In the bivariate analyses, tobacco use was statistically associated (P < .05) with wound management and near statistically associated (P = .06) with complications. In the multivariate model, after adjusting for the presence of multiple cysts and tobacco use, there was not a statistically significant difference between the 2 wound management choices in terms of postoperative complications. Conclusions: our results suggest that the choice of managing the osseous wound, ie, primary closure versus secondary intention, was not associated with increased risk of postoperative inflammatory complications. The implications of these findings are discussed below. (c) 2006 American Association of Oral and Maxillofacial Surgeons.