Role of Oral Veillonella Species in Predicting Surgical Site Infections After Maxillofacial Trauma: A Prospective Observational Study.

Introduction: There are comparatively fewer surgical site infections after craniofacial trauma than after trauma to the extremities, and the etiology is complex. Gram-negative facultative anaerobic bacteria is a common commensal in the oral cavity and has been linked to osteomyelitis and surgical site infections in prosthetic joint infections. They serve as early biological indicators.

Aims/objectives: This study aims to assess the presence of in patients presenting with maxillofacial trauma, to document the difference in colony count in patients requiring surgical intervention at different time intervals as against patients with surgical site infections, and to provide better hospital care and management so as to improve the standard of care with an attempt to prevent the possibility of postoperative surgical site infections.

Methodology: In this study, individuals with trauma/fractures of the maxillofacial region requiring surgical intervention at varied time spans, early, intermediate, and late, were included. After obtaining informed consent, the examination was done; the fracture type and site were noted, and a swab was taken on the day of admission, on the day of surgery, and on the day of discharge and given for microbiological evaluation. Findings were recorded.

Results: The primary and secondary objectives of the study were established. The mean colony count in colony-forming units/milliliter for patients undergoing early surgical intervention, on the day of admission, was 2.01E+0.6. On the day of discharge, the mean colony count was 1.51E+0.6. In contrast, for patients with surgical site infection, on the day of admission, the mean was 6.5E+0.7, and on the day of discharge, the mean colony count reduced to 4.01E+0.6. The time-colony-forming unit graph showed a difference in the colony count of in patients operated at different time intervals as against patients with surgical site infection and modified relation with a number of other oral commensals. The colony count in patients with osteomyelitis was found and compared.

Conclusion: There is a change in the colony count of species and its relation to their commensals when intervened at different time intervals. Our study indicates that the estimation of species and the colony count could aid in determining the possibility of a surgical site infection. This study also stresses on the appropriate reporting of maxillofacial trauma in cases of a poly-trauma for appropriate management.