Effects of Surgical Trauma on Peripheral White Blood Cell Count Following Major Oral and Maxillofacial Surgical Procedures

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.