Postoperative Complications After the Surgical Management of Panfacial Fractures: A Retrospective Cohort Study

Introduction: Panfacial fractures represent complex maxillofacial injuries that require extensive surgical reconstruction and are associated with a substantial risk of postoperative morbidity.This study evaluated the occurrence and pattern of postoperative complications and the factors associated with their development following the surgical management of panfacial fractures.Materials and methods: This retrospective observational cohort study was conducted at the Department of Oral and Maxillofacial Surgery of Guru Nanak Dev Dental College and Research Institute in Sunam, India.Medical records of patients who underwent surgical management of panfacial fractures between January 2018 and November 2023 were reviewed.Demographic, injury-related, operative, perioperative, and postoperative variables were analyzed.Logistic regression analysis was performed to identify the factors independently associated with postoperative complications.Results: Among the 235 patients, 67 (28.5%) developed postoperative complications.The most frequent complications were persistent sensory disturbance in 28 (11.9%)patients, surgical site infection in 19 (8.1%) patients, and secondary surgical intervention in 23 (9.8%) patients.Patients who developed complications were older and had higher frequencies of polytrauma, traumatic brain injury, open fractures, intensive care unit admission, tracheostomy, blood transfusion, and staged reconstruction.The operative duration and time to surgery were also longer in this group.Multivariable analysis identified age >40 years (adjusted odds ratio (aOR): 2.05), open fracture (aOR: 1.88), intensive care unit admission (aOR: 1.73), tracheostomy (aOR: 2.03), operative duration >6 hours (aOR: 2.32), and surgery >7 days after trauma (aOR: 1.78) as independently associated factors.Conclusion: Postoperative complications are common following the surgical management of panfacial fractures.The recognition of high-risk clinical and treatment-related characteristics may support individualized perioperative planning and closer postoperative surveillance.