30-Day Post-Operative Complications of Facial Fracture Repairs: A United States Database Study

Study Design: Cross-sectional database analysis. Objective: To define post-operative complication rates in facial fracture repair and to assess this data for patient characteristics which may be associated with post-operative complications. Methods: We performed a retrospective cohort analysis of the National Surgical Quality Improvement Program (NSQIP) database between 1 January 2015, and 31 December 2019. All patients included in this study sample must have (a) been ≥18 years old and (b) underwent surgical repair of a facial fracture during the study period by a plastic surgeon or otolaryngologist. Adverse outcomes at 30 days were characterized into four groups: superficial surgical site infection (SSI), deep SSI, organ space infection, and wound disruption. Results: In total, 2481 patients met the primary outcome of facial fracture. Among the four fracture types assessed, 1090 fractures (43.9%) were mandibular, 721 were zygomatic (29.1%), 638 were orbital (25.7%), and 32 (1.3%) were Lefort. Of the entire cohort, 25 patients (1.01%) experienced a superficial SSI, 14 patients (0.56%) presented with a deep SSI, 25 fractures (1.01%) returned with an organ space infection, and 23 patients (0.93%) experienced some type of wound disruption. Smokers had a significantly higher risk of superficial SSIs (p < 0.05) and organ space infections (p < 0.05). Conclusions: The majority of facial fracture patients do not experience post-operative complications. However, smokers and patients with diabetes mellitus were shown to be at an elevated risk of developing complications. Future research should further investigate this relationship and focus on developing interventions to improve post-operative outcomes.