A Prospective, Randomized, Double-blind Trial of the Use of Fibrin Sealant for the Bilateral Sagittal Split Ramus Osteotomy (BSSRO)

Abstract

Background: Bilateral sagittal split ramus osteotomy surgery (BSSRO) was done by splitting the mandibular ramus and re-positioning the Mandibular arch to achieve the proper dental occlusion. The common postoperative complication is bleeding and hematoma. The suction drains were used to prevent such problems. Fibrin sealant has been used in several surgical procedures to aid in hemostasis. Objective: The present study aims to study whether the intraoperative application of Fibrin sealant can reduce the amount of postoperative drainage in BSSRO operation. Materials and Methods: We performed a prospective, randomized, double-blind study of 20 patients who underwent BSSRO surgery or BSSRO with combined Le fort I and Genioplasty surgery between September 2018 and October 2019, so the total samples were 40 operative sides. Patients were randomly divided into one of two groups based on whether they received intraoperative Fibrin sealant. The volume of the wound drainage was recorded every 24 hours for 72 hours. Results: The amount of postoperative drainage of the first and second 24 hours was not significantly different. The difference in the pain score and satisfaction score between the two groups were also the same. Conclusion: The intraoperative fibrin sealant did not have a significant benefit in BSSRO to reduce bleeding. Retaining the vacuum drainage only is sufficient and cost-effective to prevent hematoma in BSSRO.