Management of cystic surgical wound of the mandible: A comparative study analyzing closed versus open wound healing

Background: The impact of surgical wounds on patients' wellbeing and the burden it places on healthcare professionals and financial resources provide opportunity to improve management strategies and prevent complications. Objective: To assess the effect of open wound healing on postoperative trismus, pain; and to record complication(s) of wound healing after enucleation of periapical periodontal (radicular) cysts of the mandible. Patients and methods: This was a prospective study of 76 patients (54 males, 22 females; aged 18-65 years, mean 37.3 +/- 13.7). The subjects were randomly assigned into two different treatment groups of closed (control, n = 38), and open (experimental, n = 38) wound healing. The subjects were treated under the same surgical protocol except that the wound in the control group were sutured. Trismus and pain were evaluated on the second, fifth, 10th and 14th days postoperatively in both groups. Results: Postoperative trismus was significantly less in the experimental group on the second and fifth postoperative days (p = 0.0000). Pain was found to be significantly less on the second, fifth and 10th days postoperatively in subjects with open wound when compared with closed (p < 0.05). The bigger the size of cystic lesion, the greater the postoperative trismus and pain (p = 0.001). Also, four (10.5%) subjects in control group developed wound dehiscence. Conclusion: This study show that open wound management technique cause less postoperative trismus, pain and complication(s). This will suggest that patients' wellbeing in the postoperative period after enucleation of periapical periodontal cysts is better with this method. (C) 2014 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.