Abstract:
BACKGROUND
The changes in white blood cell (WBC) count after major surgical procedures are well documented  in  other  surgical  specialties,  but  this  appears  not  to  be  the  case  in  oral  and maxillofacial surgery (OMFS). This study aims to determine the effects of surgical trauma on peripheral WBC count following major oral and maxillofacial (OMF) surgical procedures. 
MATERIALS AND METHOD
This study was  a prospective longitudinal study.The subjects were drawn from all consecutive  patients  booked  at  the  department  of  OMFS  for  elective  major  OMF  surgical procedures  at  the  University  of  Benin  Teaching  Hospital,  Benin  City,  Nigeria.  Those with underlying medical conditions and diseases and those older than 50 years were excluded from the  study. Interviewer-administered  questionnaires  wereused  to  collectdata.Data  werecollectedpreoperatively, immediately, then at 24-hr, 72-hr and 120-hr postoperatively. The total  WBC  and  differentials  were  obtained  from  the  full  blood count  results,  which  were analysed with an automated blood  cell counter (SYSMEX KX-21 Auto  analyser).Seventy-two patients were studied, comprising 51 (71%) males and 21 (29%) females. The age range was four months to 49 years, mean of 15.2 ±1.7 years. Descriptive (range, mean ± standard error  of  the  mean  (SEM),  frequency)  and  comparative  (ANOVA  and  Student's  T-test) statistics were done. Data were analysed with SPSS version 20 (IBM Inc., Armonk, NY, USA). Significance wasset at a P-value of <0.05.
RESULTS
There was a general postoperative increase in total WBC count following major OMF surgeries. The increase peaked at the immediate postoperative period with a gradual decline in subsequent samples in the postoperative 24-hr, 72-hr and 120-hr towards the preoperative baseline  values.  The  decline  after  120-hr  was,  however,  at  a  level  slightly  higher  than  the preoperative  level.  There  were  significant  increases  in  the  total  WBC  and  differential neutrophil  counts;  there  were  decreases  in  the  differential  lymphocyte  counts,  which  were not statistically significant. 
CONCLUSION
Evaluating the patients postoperatively using serial WBC counts may be worthwhile. This is because it may be predictive of the onset of infection or other causes of increased WBC count  that  may  require  urgent  attention  to  ensure  optimum  wound  healing  after  OMF surgery.