Role of procalcitonin, Interleukin-6 and Interleukin-10 as a predictive marker for the use of perioperative steroid in Maxillofacial trauma patients

Introduction Maxillofacial trauma often brings significant preoperative oedema challenges for surgeons. Steroids offer oedema reduction, yet potentially increase postoperative infection risks. This study explores Procalcitonin (PCT), as a marker for bacterial infection risk, and interleukins IL-6 and IL-10, which respectively signify pro-inflammatory and anti-inflammatory responses, as potential indicators of infection and inflammation in these trauma cases and thereby aid in refining perioperative steroid guidelines. Materials and Methods A prospective study was conducted at a tertiary public hospital in India from 2019-2022 on patients >18 years with facial trauma. After specific exclusions, patients were randomized into steroid (Group A) and non-steroid (Group B) groups. Various parameters including oedema, PCT, IL-6, and IL-10 levels were measured and analyzed using SPSS software. Results Out of 80 patients, 44 were in Group A and 36 in Group B. Post-24 hours, Group A showed significant oedema reduction, with 25 patients displaying a decline to mild oedema, versus 10 patients in Group B (p =0.034). However, Group A witnessed a higher infection risk, with 20 patients showing positive wound cultures versus 3 in Group B. Subgroup analysis revealed a link between higher PCT levels and infections (p =0.039). Additionally, Group A showed less intraoperative bleeding and reduced operating time. Conclusion While perioperative steroids mitigate swelling, they might increase postoperative infection risk. Elevated PCT levels indicate potential wound infections, suggesting those patients should avoid perioperative steroids. IL-6 and IL-10 trends during perioperative phases can predict pronounced oedema outcomes