Abstract：
Maxillofacial trauma often brings significant challenges for surgeons in terms of preoperative oedema. Steroids offer oedema reduction, yet potentially increase the risks of postoperative infection. This study explores procalcitonin (PCT), as a marker for bacterial infection risk, and interleukins IL-6 and IL-10, which respectively signify pro-inflammatory and anti-inflammatory responses, as potential indicators of infection and inflammation in these trauma cases and thereby aid in refining perioperative guidelines for the use of steroids. A prospective study was conducted at a tertiary public hospital in India from 2019 to 2022 on patients >18 years with facial trauma. After specific exclusions, patients were randomised into steroid (Group A) and non-steroid (Group B) groups. Various parameters including oedema, PCT, IL-6, and IL-10 levels were measured and analysed using SPSS software. Out of 80 patients, 44 were in Group A and 36 in Group B. Post-24 hours, Group A showed significant oedema reduction, with 25 patients displaying a decline to mild oedema, versus 10 patients in Group B (p = 0.034). However, Group A witnessed a higher infection risk, with 20 patients showing positive wound cultures versus three in Group B. Subgroup analysis revealed a link between higher PCT levels and infections (p = 0.039). Additionally, Group A showed less intraoperative bleeding and reduced operating time. While perioperative steroids mitigate swelling, they might increase postoperative infection risk. Elevated PCT levels indicate potential wound infections, suggesting those patients should avoid perioperative steroids. IL-6 and IL-10 trends during perioperative phases can predict pronounced oedema outcomes.
摘要：
颌面部创伤通常在术前水肿方面给外科医生带来重大挑战。类固醇可以减轻水肿，但可能会增加术后感染的风险。本研究探讨了降钙素原(PCT)，作为细菌感染风险的标志，和白细胞介素IL-6和IL-10，分别表示促炎和抗炎反应，作为这些创伤病例中感染和炎症的潜在指标，从而有助于完善围手术期使用类固醇的指南。2019年至2022年，在印度一家三级公立医院对面部创伤>18岁的患者进行了一项前瞻性研究。在具体排除之后，患者被随机分为类固醇组(A组)和非类固醇组(B组).各种参数，包括水肿，PCT,使用SPSS软件测量和分析IL-6和IL-10水平。在80名患者中，A组44人，B组36人。24小时后，A组水肿明显减轻,25名患者表现出轻度水肿的下降，对比B组10例患者(p=0.034)。然而,A组的感染风险更高，其中20例患者显示伤口培养阳性,B组为3例。亚组分析显示较高的PCT水平与感染之间存在关联(p=0.039)。此外,A组术中出血少，手术时间缩短。虽然围手术期类固醇减轻肿胀，它们可能会增加术后感染的风险。PCT水平升高表明潜在的伤口感染，建议这些患者应避免围手术期使用类固醇。围手术期的IL-6和IL-10趋势可以预测明显的水肿结局。
