Objectives: To evaluate outcomes associated with choice of wound management, i.e. primary closure or healing by secondary intent, of the residual osseous defect following excision of maxillofacial bone lesions. Methods: Using a retrospective cohort study design, we developed a sample derived from the population of patients treated for jaw lesions at Massachusetts General Hospital between 1995-2002. The primary predictor variable was wound management of the residual jaw defect after excision of the lesion. Wound management was classified as primary closure of the defect or healing by secondary intention (packing). The primary outcome variable was postoperative complication, i.e. present or absent. Other study variables included sex, age, race, smoking status, medical conditions that impair wound healing, radiographic size of lesion (cm), diagnosis, presence of multiple lesions, presence of pre-operative complications, mode of operative treatment, number of follow-up visits, and duration of follow-up. Appropriate uni-, bi-, and multivariate statistics were computed. Results: The sample was composed of 93 patients with 126 jaw lesions. Of the 126 lesions, 71.4% were managed by primary closure and 28.6% by secondary intention. In the bivariate analyses, two variables were statistically associated (p< 0.05) with wound management and with complications, i.e. tobacco use and number of cysts. In the multivariate model, after adjusting for sex, age, the presence of multiple cysts, and smoking, there was not a statistically significant difference between the two management choices in terms of postoperative complications. Conclusions: Based on the adjusted multivariate model, our results suggest that the choice of managing the osseous wound, i.e. primary closure or healing by secondary intention, was not associated with increased risk for post-operative complications. Funding sources: OMS Foundation Student Training Award (KC); NIDCR Midcareer Award in Patient-oriented Research K24-DE00448 (TBD); MGH Dept of OMS Education and Research Fund (KC, TBD); NIH/NIDCR T35-DEO7268 (KC)

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