Our aim was to clarify the incidence of impaired wound healing after open reduction and ostheosynthesis of
mandibular fractures, and to find out whether the use of
dexamethasone during the operation increased the risk. Patients were drawn from a larger group of healthy adult dentate patients who had participated in a single-blind, randomised study, the aim of which was to clarify the benefits of operative
dexamethasone after treatment of facial fractures. The present analysis comprised 41 patients who had had open reduction and fixation of
mandibular fractures with
titanium miniplates and monocortical screws through one or 2 intraoral approaches. The outcome variable was impaired healing of the
wound. The primary predictive variable was the perioperative use of
dexamethasone; other potential predictive variables were age, sex, smoking habit, type of fracture, delay in treatment, and duration of operation. Wound healing was impaired in 13/41 patients (32%) (13/53 of all fractures). The incidence among patients who were given
dexamethasone and those who were not did not differ significantly. Only age over 25 was significantly associated with delayed healing (p=0.02). The use of
dexamethasone 30 mg perioperatively did not significantly increase the risk of impaired wound healing in healthy patients with clinically uninfected
mandibular fractures fixed with
titanium miniplates through an intraoral approach. Older age is a significant predictor of impaired healing, which emphasises the importance of thorough anti-infective care in these patients during and after the operation.