Have things changed: an audit of Maxillofacial & Oral surgery procedures for the years

Abstract

Introduction: Clinical audits have become a critical component of clinical governance in today's surgical practice, as well as a prerequisite for surgeons' continued professional development. The accuracy of medical records is essential in patient diagnosis and treatment, as well as in allocating resources to fulfil clinical demands.

Study aim: This study aimed to carry out an audit of Maxillofacial and Oral Surgery (MFOS) patients treated at Chris Hani Baragwanath Academic Hospital (CHBAH) over two 12-month periods a decade apart.

Method: This was a clinical audit performed as a quantitative retrospective chart review of patients who underwent procedures at the Maxillofacial and Oral Surgery (MFOS) Unit at Chris Hani Baragwanath Academic Hospital (CHBAH), from January 2008 to December 2008 and from January 2018 to December 2018. Age, gender, diagnosis, and procedure done under both local and general anaesthesia were among the data collected from the register. The audit compared the pathologies, diagnoses, and procedures between the two decades.

Results: The study consisted of 4198 subjects (1936 from 2008 and 2262 from 2018) treated under both general and local anaesthesia. There was a significantly higher number of male subjects (p<0.001) and higher mean age of patients (33.03 years, p=0.001) in 2018 compared to 2008. There were 1320 and 1660 local anaesthetic procedures performed in 2008 and 2018, respectively (p=<0.001). Trauma (mandibular fractures in particular) was the most common preoperative diagnosis in 2008 (n=587) and 2018 (n=394). A statistically higher number of open reduction internal fixation (p<0.001) and closed reductions (p<0.001) for fractured mandible was performed in 2008 compared to 2018. Conversely, there were statistically more dentoalveolar procedures in 2018 compared to 2008 (all p=<0.00).

Conclusion: Although craniofacial trauma remains the most common preoperative diagnosis for treatment under general anaesthesia, our data show a significant decline in trauma-related surgery. Conversely, thenumber of other surgical procedures performed under local anaesthetic has significantly increased from 2008 to 2018. We recommend that more surgical audits be conducted to include data such as bed facilities, human resources, waiting periods in the clinic and theatre, and referral patterns from surrounding hospitals. The credence and scientific value of data from audits such as this will be significantly enhanced by the introduction of a computer-based data collection system.