Oral and Craniofacial Maxillofacial Plastic Surgery

Purpose: To analyze the demographic, clinical, and microbiological profile of patients
presenting to our unit with chronic wounds of various etiologies with an intent to give a
current overview of chronic wounds.
Patients and Methods: We performed a prospective observational study of patients
presenting with chronic wounds from October 2018 to September 2019. The study was
conducted at the Department of Burns and Plastic Surgery of a tertiary care institute in a nonmetropolitan
city in Central India. A total of 103 patients were included in the study. Data
collected from the patients included demographic details, history, clinical features, and
relevant laboratory reports. Wound swabs obtained by Levine’s technique were sent for
culture and sensitivity studies. Treatment was instituted according to the clinical picture and
modified if necessary. Progress was monitored until the wound healed, either by conservative
management or by surgical intervention. Patients were followed up for six months thereafter.
Results: Most of the patients presented with lower limb wounds (n=81, 78.64%). Swab
specimens from 103 wounds were cultured. Among the isolates, gram-negative organisms
were more common than gram-positive organisms. Staphylococcus aureus was the most
common species isolated, followed by Pseudomonas aeruginosa. The frequency of infections
caused by other gram-negative organisms like Klebsiella pneumoniae, Escherichia coli, and
Proteus mirabilis was on the rise. There were significant differences in the patterns of
antimicrobial resistance in our patients. Sharp debridements were required in almost all
cases for wound preparation. Most of the patients (n=74, 71.84%) underwent surgical
intervention for achieving wound closure. Split-thickness skin grafting (STSG) was the
most common surgical intervention performed (n=45, 43.68% patients), followed by local
and distant flaps.
Conclusion: Our study gives a current overview of the causes, clinical presentation,
prevalent microbial flora, and their antibiotic susceptibilities prevalent in chronic wounds
presenting to our unit. Treatments administered are discussed with emphasis on the different
reconstructions performed.

Behcet's syndrome is an autoimmune disease of the seronegative vasculitic type, with a disease of vessels of variable caliber. It is mainly characterized by oral ulcers, genital ulcers and uveitis. The purpose of this case is to describe the oral manifestations and therapeutic behavior to be followed before a patient with Behcet syndrome. For our purpose, the case of a 20-year-old patient, female, black race, urban origin, who goes to the emergency departments of Maxillofacial Surgery of the body of guard of the Provincial Hospital Dr. Gustavo Aldereguía Lima in the province of Cienfuegos, referred by the specialist in Comprehensive General Stomatology who provided services in the area of health corresponding to the patient for presenting multiple ulcerated lesions throughout the oral cavity and lips. It was concluded that oral ulcers in Behcet's disease are the first clinical manifestation, which in most cases, lead the patient to seek medical help and are considered by countless authors as the cornerstone to reach the diagnosis of this disease. A total of 14 bibliographies were consulted.

Aims  and  Objectives:  To study the prevalence of jaw swellings among maxillofacial surgery patients, the demographics of the patients with jaw swellings and the radiological characteristics of these jaw swellings seen over a period of fifteen years.Methods: Descriptive retrospective-prospective study. (A retrospective review of cases seen in a ten year period  between 1996 and 2005 and a prospective study of cases seen in a five year period between 2006 and 2010). Data of interest were age, gender, anatomic location of the lesions; radiographic characteristics of the lesions- radiolucent, radio-opaque or mixed radiolucent/radio-opaque lesions and the nature of the borders on plain radiographic films.Results: There were 38,220 attendances to the clinic within the period studied and 1,513 of these presented with maxillofacial swellings, made up of 660 males and 853 females. This is an incidence of 4.0% of maxillofacial swellings among attendants of the maxillofacial clinic.Age range (median) of patients with maxillofacial swelling is 1-87 (30) years. Radiolucency was the most presented radiographic form 1067, radiopaque lesions were 228 and mixed forms were 218 of all the cases of swellings included in the study. Most, 1182 of the lesions are located in the mandible. There were 505 of these lesions in the posterior mandible.Conclusion: This study concludes that a sizeable number of patients attending to see a maxillofacial surgeon present with a facial swelling, with a slight female predilection and most of the lesions occur in the posterior mandible. Advocacy for purposeful preventive measures and a more equitable distribution of available human and material resources is recommended. Different  pathologies  in  the  maxillofacial  region  present  with swelling. Swellings of the jaw are signs of inflammatory, cystic  and  neoplastic  disorders  of  the  jaw  caused  by  hypertrophy,  hyperplasia, neoplasia and pooling of fluids [1]. These may or may not be associated with pain or ulcerations. These swellings have  similar  clinical  features  and  require  further  evaluation  to  differentiate  them.  Many  diagnostic  tools  exist  for  diagnostic  and  therapeutic  guidance  for  surgeons  to  precisely  diagnose  types  as  well as delineate the extent, and location of maxillofacial swellings [2,3]. Among the myriads of cross-sectional imaging modalities developed  to  evaluation  and  diagnosis,  radiological  modality  is  a  first-line and the most important evaluation [4,5] of maxillofacial swellings.