Study on diachronic changes of inflammatory cytokines and perioperative management in orthognathic surgery

In the perioperative period, perioperative infections are the most commonly observed postsurgical complication. For this reason, potent antibacterial drugs with wide spectrums are administered at huge doses for long periods of time, which has resulted in the appearance of microbes with multiple drug resistance. Therefore, we believe an appropriate administration period for preventive antibacterial drugs should be evidence-based. In the present study, we investigated the administration periods for preventive antibacterial drugs as perioperative management using the changes over time of cytokines as preturgical and postsurgical inflammatory signs in orthognathic surgery (sagittal splitting ramus osteotomy). The cytokines IL-lei, IL-6, IFNy, IL-10, and IL-15 were measured over time and their levels were compared with biological markers of inflammation, such as CRP, which accompany surgical invasion. The level of the inflammatory cytokine IL-6 increased beginning immediately after the surgery and peaked one day after surgery, following which it decreased . IL-15 reached its peak value 2 days after surgery and then it declined. Since IL-6 started to increase immediately after the surgery compared to the WBC count and CRP, it may be possible to use IL-6 early on to assess the degree of invasiveness, while IL-15 is an important cytokine for understanding the biological responses after surgery. Thus, measuring IL-6 and IL-15 is clinically useful for assessing the degree of invasiveness and postsurgical biological response, and it is believed that an administration period for preventive antibacterial drugs of 2 days or less after surgery is appropriate.