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Postoperative leukocyte changes in facial fracture patients: a randomized prospective study with short-term dexamethasone

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Abstract

Purpose

We investigated leukocyte changes in facial fracture patients undergoing surgery. Of specific interest was the effect of perioperative dexamethasone on leukocyte changes.

Methods

Facial fracture patients were randomized to receive perioperatively a total dose of 30 mg of dexamethasone, whereas patients in the control group received no glucocorticoid. All patients received antibiotics until postoperative days 7–10. Leukocyte count was measured on postoperative days 1 and 2. Clinical infections were observed during the follow-up.

Results

A total of 110 adult patients were included in the study. Postoperative leukocytosis was found in 91.2% of patients receiving dexamethasone and in 67.9% of controls. Dexamethasone was associated strongly with leukocyte rise (p < 0.001) on both postoperative days. Transoral surgery and younger age (≤40 years) showed significant associations with leukocytosis on the first postoperative day (p = 0.002). In regression analyses, dexamethasone associated with leukocytosis most significantly (p < 0.001). No association was found with infections.

Conclusions

Dexamethasone use was the most significant predictor of leukocyte rise. As a drug response, perioperative dexamethasone caused sixfold postoperative leukocytosis. High-dose dexamethasone-induced leukocytosis may confuse the clinical decision-making especially in assessment of early infections.

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Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, 00029, Helsinki, Finland

    Johanna Snäll, Jyrki Törnwall & Hanna Thorén

  2. Institute of Dentistry, University of Eastern Finland, Kuopio, Finland

    Anna Liisa Suominen

  3. Department of Oral and Maxillofacial Surgery, Kuopio University Hospital, Kuopio, Finland

    Anna Liisa Suominen

Authors
  1. Johanna Snäll
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  2. Jyrki Törnwall
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  3. Anna Liisa Suominen
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  4. Hanna Thorén
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Corresponding author

Correspondence to Johanna Snäll.

Ethics declarations

The study protocol was approved by the Ethics Committee of the Department of Surgery and the Internal Review Board of the Division of Musculoskeletal Surgery, Helsinki University Hospital, Finland (Dno 33/E6/06). The study has been registered at Helsinki University Hospital, Helsinki, Finland under identification number HUS2325.

Informed consent

Informed consent was obtained from all participants in the study.

Funding

The study was not supported by any funding source.

Competing interests

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Snäll, J., Törnwall, J., Suominen, A.L. et al. Postoperative leukocyte changes in facial fracture patients: a randomized prospective study with short-term dexamethasone. Oral Maxillofac Surg 21, 241–246 (2017). https://doi.org/10.1007/s10006-017-0623-4

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  • DOI: https://doi.org/10.1007/s10006-017-0623-4

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