High-energy Gunshot Wounds to the Face

Vásconez, Henry C.; Shockley, Mark E.; Luce, Edward A.

doi:10.1097/00000637-199601000-00005

Cited by 71 publications

(51 citation statements)

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“…9 Despite all efforts during the reconstructive process, resulting aesthetic deformities and functional defects are inevitable. 1,10,11 Because of the resulting aesthetic and functional deformities, it is essential to reconstruct them both. In this group of patients, the objective assessment of the results is as important as the reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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Late Oropharyngeal Functional Outcomes of Suicidal Maxillofacial Gunshot Wounds

Zor

Aykan

Coşkun

et al. 2015

Journal of Craniofacial Surgery

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Section: Discussionmentioning

confidence: 99%

“…The entry wounds are usually at the submental area, and the exit wounds are at the midfacial or frontal area. 1,2 Such wounds result in injury and tissue loss of both the soft and bony tissues. These tissue injuries and tissue loss zones affect all of the lower and midfacial structures and impair swallowing, speech, and respiratory functions of the face.…”

mentioning

confidence: 99%

Late Oropharyngeal Functional Outcomes of Suicidal Maxillofacial Gunshot Wounds

Zor

Aykan

Coşkun

et al. 2015

Journal of Craniofacial Surgery

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“…6,10 Microvascular FTT has contributed to a paradigm shift in the timing of definitive reconstruction for GSW-related maxillofacial trauma, with several authors advocating earlier reconstruction (within 24Y48 h) to reduce the opportunity for refractory scar contracture and earlier rehabilitation of deglutition and speech. 3,6,8,9,13,14 However, a key issue Yes ORIF of maxilla that must be addressed when considering immediate surgical repair of this unique subset of trauma patients is the underlying psychiatric illness. We believe that patients who attempted suicide (4/6 patients in this study) should have their underlying psychiatric issues treated before final reconstructive surgery is undertaken because immediate surgical concerns with associated bodily discomfort and emotional distress may easily overshadow chronic psychiatric problems.…”

Section: Discussionmentioning

confidence: 99%

Inpatients With Gunshot Wounds to the Face

Sun

Patil

Harmych

et al. 2012

Journal of Craniofacial Surgery

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Microvascular free tissue transfer (FTT) is an increasingly used method of reconstruction for traumatic defects of the head and neck. We describe the immediate management, FTT reconstruction techniques, and outcomes of 6 individuals who sustained maxillofacial gunshot trauma and were treated at a single tertiary-care level I trauma center. All 6 patients were white men with a mean age of 33 years. The mandible, nose, and orbital contents were the most frequently affected critical structures. All patients initially underwent primary wound debridement and tracheostomy, with concurrent maxillomandibular wire fixation and/or midface or mandible plate fixation in 5 patients. The mean time from injury to definitive FTT was 38 days. Five patients underwent fibula osteocutaneous FTT and 1 underwent radial forearm fasciocutaneous FTT. One patient also underwent concurrent local tissue rearrangement and pedicled flap surgery for nasal reconstruction. The mean hospital length of stay after FTT was 6 days. All FTT survived without necrosis. Oral incompetence and poor cosmesis from undesirable scarring patterns were the most common long-term complications. In summary, successful reconstruction of head and neck defects caused by gunshot trauma begins with airway stabilization, wound management, and bony fracture reduction and fixation. Definitive microvascular FTT is a useful method of repairing traumatic head and neck defects, although long-term functional and cosmetic complications may still occur.

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“…Additionally, by allowing adequate time for oedema resolution, the decrease in inflammation provides for a better assessment of the pre-traumatic facial structure. However, in a review of 33 facial reconstructions, Vasconez et al 29 observed similar infection rates between delayed and immediate post-gunshot wound reconstruction. The delayed group also demonstrated an increased incidence of wound contracture, which resulted in significantly more structural and functional deformity.…”

Section: Timing Reconstructionmentioning

confidence: 93%

Current trends in the management of maxillofacial gunshot injuries: a critical review

Motamedi¹,

Ebrahimi²,

Shams³

2013

Annals of Oral and Maxillofacial Surgery

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Introduction Firearm injuries continue to be a major public health problem. Herein, we review and evaluate the current trends in the management of maxillofacial gunshot injuries. Conclusion Ease of reduction and fixation of fractures, easier restoration of occlusion, prevention of contracture and displacement, ability to reduce displaced or avulsed teeth, early mandibular mobilization, less scarring, less anxiety and shorter hospital stay are among the many benefits associated with comprehensive definitive management of maxillofacial gunshot injuries.

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High-energy Gunshot Wounds to the Face

Cited by 71 publications

References 0 publications

Late Oropharyngeal Functional Outcomes of Suicidal Maxillofacial Gunshot Wounds

Late Oropharyngeal Functional Outcomes of Suicidal Maxillofacial Gunshot Wounds

Inpatients With Gunshot Wounds to the Face

Current trends in the management of maxillofacial gunshot injuries: a critical review

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