Does Training Background Influence Outcomes after Coronal Scalp Incision for Treating Craniomaxillofacial Injuries?: A German Pilot Study
Issued Date
2023-06-01
Resource Type
ISSN
09728279
eISSN
0974942X
Scopus ID
2-s2.0-85147271827
Journal Title
Journal of Maxillofacial and Oral Surgery
Volume
22
Issue
2
Start Page
442
End Page
452
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Maxillofacial and Oral Surgery Vol.22 No.2 (2023) , 442-452
Suggested Citation
Pitak-Arnnop P., Subbalekha K., Tangmanee C., Sirintawat N., Meningaud J.P., Neff A. Does Training Background Influence Outcomes after Coronal Scalp Incision for Treating Craniomaxillofacial Injuries?: A German Pilot Study. Journal of Maxillofacial and Oral Surgery Vol.22 No.2 (2023) , 442-452. 452. doi:10.1007/s12663-023-01860-4 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/81544
Title
Does Training Background Influence Outcomes after Coronal Scalp Incision for Treating Craniomaxillofacial Injuries?: A German Pilot Study
Other Contributor(s)
Abstract
Objectives: To examine outcomes of the coronal scalp approach to craniomaxillofacial (CMF) fractures performed by oral-maxillofacial or craniofacial plastic surgery residents (OMFS/CFPS-Rs) vs. trauma surgery residents (TS-Rs), and to determine differences in treatment outcomes between both operator groups. Methods: This retrospective cohort study enrolled a sample of CMF fracture adult patients treated via the coronal approach in a German level one trauma center during a two-year interval. The predictor variable was training background (OMFS/CFPS-Rs vs. TS-Rs; each n = 5). All trainees must assist in ≥ two surgeries before self-performance. The main outcomes were length of hospital stay (LHS) and coronal flap-related complications (CFRCs). Appropriate statistics were computed at α = 95%. Results: Of the 97 patients identified during the study period; 71 of whom (19.7% females; mean age, 40.2 ± 15.2 years; 46.5% operated by TS-Rs; 38% combined upper and midfacial fractures) met the inclusion criteria. Operative time, LHS, CFRCs, readmission rates, and post-discharge emergency room visits were not significantly different between the trainee groups. 60% of CFRCs were visible/unfavorable or hypertrophic scar with/without alopecia. The number needed to treat of short LHS was 44 (95% confidence interval [CI], 3.9 to 4.8), the number needed to harm of CFRCs was 14 (95% CI, 3.6 to 7.4), i.e., the likelihood to be helped or harmed was 0.32. Conclusions: Coronal flap raising by OMFS/CFPS-Rs does not appear beneficial over that by TS-Rs in terms of LHS and CFRCs evaluated until postoperative month six. Trainees from any surgical specialties could gain partial independence from skilled surgeons in CMF trauma “sub-steps” and favorable clinical outcomes. Further studies in a larger sample cohort are required to confirm this pilot data.