The process of orthognathic care in an NHS region

Abstract

INTRODUCTION The aim of this study was to evaluate, within an NHS region, the process of care and the standard of record for orthognathic patients. PATIENTS AND METHODS A retrospective analysis of the medical records of 372 patients who underwent orthognathic surgery 1 January 1995 and 31 April 2000 in the South West Region of the UK. RESULTS Most patients underwent joint orthodontic and maxillofacial planning and had third molars extracted under general anaesthesia prior to orthognathic surgery. There was a significant difference in the median operation times and length of stay for bimaxillary surgery (4 h/4 days) compared with single jaw surgery (2 h/3 days; P < 0.001). Just over 15% of patients required removal of internal fixation plates after surgery, with nearly 90% of these requiring a further episode of general anaesthesia. The level of record keeping and patient review was variable with no regional standardisation. CONCLUSIONS This study is evidence of a generally acceptable standard in the process of care, which was found to follow international and national practices. However, at the time of the study there was no regional protocol for patient records or patient review, highlighting the need for the establishment of a regional database.