What are the common postoperative complications following maxillofacial surgery, and how can they be managed in primary care?

Common postoperative complications following maxillofacial surgery include pain, infection, bleeding, swelling, venous thromboembolism (VTE), and impaired wound healing.

In primary care, management focuses on early recognition and supportive care. Pain should be managed using a multimodal analgesic approach, including oral paracetamol and ibuprofen unless contraindicated, with opioids reserved for moderate to severe pain and used to facilitate functional recovery as soon as possible after surgery ².

Infection requires prompt assessment; if suspected, appropriate antibiotic therapy should be initiated or the patient referred back to secondary care if severe.

Bleeding or haematoma formation should be monitored; minor bleeding may be managed conservatively, but significant or ongoing bleeding warrants urgent referral.

Swelling is common and can be managed with elevation, cold compresses initially, and analgesia.

Venous thromboembolism (VTE) is a recognized risk after maxillofacial surgery, especially in patients with additional risk factors. Mechanical prophylaxis such as anti-embolism stockings or intermittent pneumatic compression should be continued until mobility is restored, and pharmacological prophylaxis with low molecular weight heparin (LMWH) may be considered if the risk of VTE outweighs bleeding risk ¹.

Primary care should also monitor for signs of impaired wound healing and provide patient education on wound care and when to seek urgent review.