Knowledge, Attitudes and Practices of Selected Filipino Surgeons Regarding the Clinical Practice Guidelines on the Management of Isolated Mandibular Body Fractures In Adults
DOI:
https://doi.org/10.32412/pjohns.v41i1.2873Keywords:
mandibular fractures, maxillofacial injuries, practice guideline, self-administered questionnaire, otolaryngologists, general surgeonsAbstract
Objectives: To initially assess the knowledge, attitudes and practices of selected target users of the Clinical Practice Guidelines on the Management of Isolated Mandibular Body Fractures in Adults nationwide. Specifically, to assess the level of awareness of selected Filipino surgeons who are expected to use this clinical practice guideline and to identify gaps in knowledge and practices among these surgeons using the key action statements in the clinical practice guideline.
Methods:
Design: Cross-Sectional Study
Setting: Platform-Based Online Survey
Participants: 295 Otorhinolaryngologists – Head and Neck surgeons (ORL-HNS)/Craniomaxillofacial surgeons (CMFS) and General surgeons (GS) / Plastic and Reconstructive surgeons (PRS) consultants and residents/fellows-in-training
Results: Among 295 surgeon respondents (47.46% ORL-HNS consultants), 75.25% were aware of PACMFS guidelines. In general, knowledge scores were high [median (IQR): 12 (11–13) vs 11 (IQR 9–13), U = 11726, n1= 204, n2 = 91, p < .001; Mann-Whitney], with >90% accuracy for the tongue blade test (93.22%), non-contrast CT for fracture assessment (95.93%), closed reduction with maxillomandibular fixation for favorable fractures (98.31%), and ORIF with plates and screws for unstable fractures (98.64%); lower accuracy was observed for imaging modality sequencing (50.85%) and antibiotic selection (penicillin - 70.41%). Consultants and ORL-HNS/CMFS specialists demonstrated significantly higher knowledge and were guideline-concordant than trainees and other specialties. Attitudes toward multidisciplinary collaboration, evidence based practice updates, and cost-effectiveness were nearly universal (over 99%). Most self reported practices—such as requesting a panoramic radiograph (68.14%), obtaining plain mandibular radiographs when panoramic imaging was unavailable (91.53%), using Barton’s bandage for temporary immobilization (89.83%), administering prophylactic antibiotics for mucosal/ skin breach (98.31%), and initiating analgesia at 4/10 pain score (85.71%)—were also guideline-consistent.
Conclusion: Filipino surgeons in this survey demonstrated generally strong alignment with the published Philippine Academy of
Craniomaxillofacial Surgery (PACMFS) Clinical Practice Guidelines for the management of isolated mandibular body fractures in adults,
showing high knowledge and consistent self-reported adherence for key diagnostic steps, imaging selection when resources allow,
temporary stabilization, and definitive operative decision-making.
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Copyright transfer (all authors; where the work is not protected by a copyright act e.g. US federal employment at the time of manuscript preparation, and there is no copyright of which ownership can be transferred, a separate statement is hereby submitted by each concerned author). In consideration of the action taken by the Philippine Journal of Otolaryngology Head and Neck Surgery in reviewing and editing this manuscript, I hereby assign, transfer and convey all rights, title and interest in the work, including copyright ownership, to the Philippine Society of Otolaryngology Head and Neck Surgery, Inc. (PSOHNS) in the event that this work is published by the PSOHNS. In making this assignment of ownership, I understand that all accepted manuscripts become the permanent property of the PSOHNS and may not be published elsewhere without written permission from the PSOHNS unless shared under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.
