Bimaxillary osteotomies as a less than 24-hour stay procedure

Abstract

Historically, Le Fort I bimaxillary osteotomy (BMO) in the UK has generally been regarded as a surgical procedure requiring a full day of operating with subsequent hospital stay for several days, including potential intensive care admission and blood transfusions. Following the introduction of the national standards on day case surgery in the UK in 2011, the authors have routinely and successfully performed bilateral sagittal split osteotomy surgery (BSSO) as a day-case procedure, whilst achieving excellent patient satisfaction since 2015. The desire to improve efficiency in the management of patients requiring short-term surgical admission, was also applied to BMO procedures, with aims for a short, less than 24 h (<24-hour) stay admission, for patients with appropriate medical and social circumstances. With day surgery and short stay admission considered fundamental to modern care, this presents multiple benefits for both patients and the National Health Service (NHS). Our aim was to demonstrate that our BMOs conform to current national standards, and could be carried out both successfully and safely, as a <24-hour stay procedure. All patients undergoing BMOs (n = 165) were planned as a <24-hour stay procedure between 2012 and 2023 by the same consultant. Demographic details, operative time, length of stay, and re-admittance rates were reviewed retrospectively. Of these patients, 96.4% (n = 159) were discharged within 24 h of the procedure. Four patients (2.4%) were discharged within 24–48 h, and two (1.2%) within 48–72 h. There were no re-admissions within 48 h of discharge. We concluded that BMOs, along with concurrent wisdom tooth removal, can be carried out successfully and routinely as a single, short stay procedure. However, to reduce the rate of prolonged admission, it is recommended that a strict perioperative protocol be followed.