Comparative evaluation of use of face ice pack wrap and Romo-Vac drain in post-operative oedema and pain of mandibular fractures: a randomized controlled trial

Abstract

Objectives: This study aimed to compare the effectiveness of cryotherapy using a facial ice pack wrap and Romo-Vac drainage in postoperative management of patients undergoing open reduction and internal fixation (ORIF) for mandibular fractures, with a focus on reduction of oedema, pain relief, mobility limitation, and patient satisfaction. Materials and Methods: A prospective, randomized, open-label, monocentric clinical trial was conducted on 30 patients with mandibular fractures requiring ORIF. Participants were randomly assigned to receive either a facial ice pack wrap (Group I) or Romo-Vac drainage (Group II) postoperatively. Standardized surgical and pharmacological protocols were followed. Oedema was assessed using linear facial measurements on Days 0, 1, 3, 7, and 21. Pain was measured using a visual analogue scale, and subjective parameters—comfort, mobility, and satisfaction—were evaluated via structured patient questionnaires. Results: Group I demonstrated significantly reduced postoperative swelling compared to Group II (P=0.001), with the largest difference on Day 3. Pain scores were consistently lower in Group I, though not statistically significant. Group I participants reported significantly less discomfort (P=0.001), fewer mobility limitations (P=0.001), and greater overall satisfaction (P=0.001) than those in Group II. The Romo-Vac drain was associated with more postoperative inconvenience and movement restrictions. Conclusion: Cryotherapy using a facial ice pack wrap is more effective than Romo-Vac drainage in minimizing postoperative oedema and discomfort following ORIF in mandibular fracture cases. It also improves patient satisfaction and facilitates early mobility, supporting its use as a preferred postoperative care strategy.