Abstract
Oral and maxillofacial (OMFS) facial fractures account for approximately 5%-10% of
presentations to emergency departments in the UK. Although most trauma is treated
operatively, different methods of surgery exist for the same clinical presentation
and non- surgical management is in some cases appropriate. Analysis of patient morbidity
is an essential component of clinical governance in surgery. OMFS units in the UK
should hold regular morbidity and mortality (M&M) meetings, but no consensus exists
for which cases should be discussed. For example, most units focus only on cases treated
surgically, primarily unexpected returns to theatre. Finally, there is no agreed structure
for describing how complications occur and a focus on terms such as error. The aim
of this review is to help inform which patients should be discussed in M&M meetings
based on existing scoring systems. A systematic review of the literature has been
undertaken using the Preferred Reporting in Systematic Reviews and Meta-Analysis methodology.
Databases searched were PubMed and Science Direct. Eleven unique papers and a companion
article met the criteria and were analysed. Many M&M classification systems exist,
but these systems are unsuited for maxillofacial purposes. There is a need for a novel
system which is tailored to the specialty.
Keywords
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References
- Surgical or conservative treatment for mandibular condyle fractures.Medwave. 2018; 18: e7352
- The conservative management of facial fractures: indications and outcomes.J Plast Reconstr Aesthet Surg. 2007; 60: 146-151
- Management of oral and maxillofacial trauma during the first wave of the COVID-19 pandemic in the United Kingdom.Br J Oral Maxillofac Surg. 2021; 59: 867-874
- What is clinical governance?.BJA Education. 2019; 19: 174-175
- An analysis of surgical complications; a tool to improve surgical outcome.Nepal Med Coll J. 2014; 16: 115-118
Royal College of Surgeons. Morbidity and Mortality Meetings. Available from: URL://www.rcseng.ac.uk/standards-and-research/standards-and-guidance/good-practice-guides/morbidity-and-mortality-meetings/ (last accessed 5 September 2022).
- Morbidity and mortality meetings: gold, silver or bronze?.ANZ J Surg. 2018; 88: 966-974
- Morbidity and mortality conferences in general surgery: a narrative systematic review.Can J Surg. 2020; 63: E211-E222
- Use of Clavien-Dindo classification in reporting and grading complications after urological surgical procedures: analysis of 2010 to 2012.J Urol. 2013; 190: 1271-1274
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.PLoS Med. 2009; 6: e1000100
- Classifying morbidity and error in oral and maxillofacial trauma using the clavien-dindo classification: a prospective pilot study.BJS. 2021; 108 (znab259.638)
- An adapted Clavien-Dindo scoring system in trauma as a clinically meaningful non-mortality endpoint.J Trauma Acute Care Surg. 2017; 83: 241-248
- Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients.Eur Surg. 2018; 50: 256-261
- Culture of blame—an ongoing burden for doctors and patient safety.Int J Environ Res Public Health. 2019; 16: 4826
- A consensus-based criterion standard for trauma center need.J Trauma Acute Care Surg. 2014; 76: 1157-1163
- Facial fracture repair and diabetes mellitus: An examination of postoperative complications.Laryngoscope. 2017; 127: 809-814
- Effects of an examiner’s positive and negative feedback on self-assessment of skill performance, emotional response, and self-efficacy in Korea: a quasi-experimental study.BMC Med Educ. 2019; 19: 142
Article info
Publication history
Published online: August 22, 2022
Accepted:
August 17,
2022
Identification
Copyright
Crown Copyright © 2022 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.