The orthognathic patient’s postoperative care points The orthognathic facial deformity refers to the abnormalities in the volume and morphology of the jaws caused by the abnormal development of the jaws, the abnormal position relationship between the upper and lower jaws and between the jaws and other bones of the craniofacial area, and the accompanying dental relationship and oral system functional abnormalities and facial morphology. The characteristics of modern orthognathic surgery: 1, mainly for oral and maxillofacial surgery and orthodontics combined, not only to correct jaw deformity but also to correct malocclusion. 2. In addition to careful and comprehensive clinical examination and diagnosis, each orthognathic surgery patient must undergo projection measurement analysis and prediction before surgery to confirm the correctness of clinical diagnosis and select the best surgical plan. 3.Each orthognathic surgical patient must go through model surgical design and spell out the ideal fit relationship on the model. (1) Clinical manifestations 1. Developmental jaw deformities: (1) Deformities of the jaw in the anterior and posterior directions: such as maxillary protrusion, maxillary recession, mandibular protrusion, mandibular recession, etc. (2) Vertical deformity of jaws: long face syndrome, short face syndrome, jaw angle hypertrophy with masticatory muscle hypertrophy. (3) Left and right lateral deformities of the jaws (4) Dental malocclusion 2. Acquired deformities Maxillofacial deformities secondary to resection of maxillary and mandibular tumors, misaligned healing of bone blocks or bone defects after maxillary and mandibular fractures, ankylosis of the temporomandibular joint for various reasons, etc. 3. Craniofacial anomalies syndrome: acrofacial syndrome, craniofacial dysplasia syndrome, eyelid-zygomatic- mandibular dysplasia syndrome, first and second gill arch syndrome. (B) Care measures Orthognathic surgery uses the surgical approach, including moving the jaw, changing the occlusal relationship and osteotomy simply for the purpose of improving facial shape. 1. Pre-operative preparation Pre-operative care according to oral and maxillofacial surgery. After admission, improve all laboratory tests and report any abnormalities to the doctor in time. Develop good living habits, quit smoking and drinking, and prevent colds. Maintain adequate sleep and take in sufficient nutrition. The night before the operation, the patient is too nervous to sleep because of the operation, so you can give diazepam tablets orally as prescribed by the doctor. Explain the purpose of gastric tube and urinary catheter. Explain the types of nasal fluid feeding and the knowledge of diet and nutrition. Explain the common postoperative symptoms such as swelling, sore throat, fever, short period of perioral numbness, etc. to eliminate patients’ doubts. Teach patients how to communicate after surgery, such as using pen and paper to write down what they need to express after surgery. 2. Postoperative care (1) After general anesthesia surgery Keep the airway open: closely observe the vital signs, observe the patient’s breathing, tilt the head to the side to facilitate the discharge of oral secretions, and aspirate the secretions in the nasal and oral cavities in a timely manner. Loosely cover the patient’s mouth and nose with two layers of wet gauze to allow the patient to inhale moist air. 2) Local cold compresses: Cold compresses with ice bags on the surgical site within 24 hours after surgery can effectively reduce postoperative edema. Treatment of nausea and vomiting: intermittent gastrointestinal decompression, aspiration of blood and gastric contents accumulated in the stomach, appropriate administration of antiemetic drugs, such as intermaxillary traction, bedside preparation of wire scissors, ligature wire should be cut when vomiting to prevent asphyxiation. (2) Return to the ward and hand over to the nurse of the monitoring ward to understand the patient’s condition. (3) Elevate the head of the bed 30 degrees-40 degrees and make the patient semi-recumbent to reduce facial swelling and bleeding and to facilitate the discharge of intra-oral secretions, and prepare a suction device at the bedside. (4) Apply antibiotic eye ointment to the lips and corners of the mouth to keep them clean and moist to avoid infection and promote healing. (5) Aspirate the secretions in the mouth in a timely manner, with gentle suction movements and avoiding the wound. Give nebulized inhalation for 5 days, 2 times/day, which can dilute sputum and reduce pharyngeal pain. (6) Retain the gastric tube.