Early Definitive Bone and Soft-Tissue Reconstruction of Major Gunshot Wounds of the Face

Gruss, Joseph S.; Antonyshyn, Oleh; Phillips, John H.

doi:10.1097/00006534-199103000-00008

Cited by 139 publications

(105 citation statements)

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“…[1][2][3][4] Bone morphogenetic proteins (BMPs) are osteoinductive molecules that promote bone regeneration. 5,6 Validation of this BMP-inspired physiological process has been documented in preclinical (reviewed 7 ) and clinical 8,9 reports.…”

Section: Introductionmentioning

confidence: 99%

Tissue-engineered bone biomimetic to regenerate calvarial critical-sized defects in athymic rats

Winn

Schmitt

Buck

et al. 1999

J. Biomed. Mater. Res.

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A tissue-engineered bone biomimetic device was developed to regenerate calvaria critical-sized defects (CSDs) in athymic rats. Well-documented evidence clearly confirms that left untreated, CSDs will not spontaneously regenerate bone. To accomplish regeneration, four candidate treatments were assessed: porous poly(D,L-lactide) and type I collagen (PLC), PLC and human osteoblast precursor cells (OPCs) at 2 x 10(5) (PLC/OPCs), PLC and 50 microg of recombinant human bone morphogenetic protein-2 (PLC/rhBMP-2), and PLC/OPCs/rhBMP-2 (the bone biomimetic device). The hypotheses for this study were PLC/OPCs/rhBMP-2 would promote more new bone formation in CSDs than the other treatments and the amount of bone formation would be time dependent. To test the hypotheses, outcomes from treatments were measured at 2 and 4 weeks postoperatively by radiomorphometry for percent radiopacity and by histomorphometry for square millimeters of new bone formation. Data were analyzed by analysis of variance and Fisher's protected least significant difference for multiple comparisons with p< or = 0.05. At 2 and 4 weeks, radiomorphometric data revealed PLC/rhBMP-2 and PLC/OPCs/rhBMP-2 promoted significantly more radiopacity than either PLC or PLC/OPCs. Histomorphometry data at 2 and 4 weeks indicated significantly more new bone formation for PLC/rhBMP-2, PLC/OPCs/rhBMP-2, and PLC/OPCs compared to PLC. By 4 weeks, PLC/OPCs/rhBMP-2 and PLC/rhBMP-2 had regenerated the CSDs with more new bone than the other treatments; the quantity of bone at 4 weeks for these treatments was greater than at 2 weeks.

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Section: Introductionmentioning

confidence: 99%

Tissue-engineered bone biomimetic to regenerate calvarial critical-sized defects in athymic rats

Winn

Schmitt

Buck

et al. 1999

J. Biomed. Mater. Res.

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“…Many methods have been used for reconstruction of the face after shotgun injuries. After bony reconstruction is accomplished, soft tissue reconstruction can be completed by direct closure or local, regional, or free vascularized flap [19]. Arnold & Irons [20] used the gastroomental free flap in a patient with close-range shotgun blast to his face as well as autogenous ribs for reconstruction of the mandibular defects.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of Facial Gunshot Wound by the Cervicopectoral Flap

Copçu

Aktaş

Copcu

et al. 2003

European Journal of Trauma

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Background: Reconstruction of large facial defects secondary to shotgun blast to the face is a very difficult task in surgery. Case Study: We report on a 34-year-old female patient with suicidal shotgun injury to her face delivered by a hunting rifle at close range into her mouth. She showed a large right cheek defect and a mandibular fracture. The defect was closed by a cervicopectoral fasciocutaneous flap; the mandibular fracture was managed with a titanium reconstruction plate. Good aesthetic and functional results were achieved 1 year after reconstruction. Conclusion: Early definitive reconstruction of shotgun injuries is still controversial. The cervicopectoral flap has many advantages. It is easy and secure to harvest and possesses skin properties similar to the face. The flap is quite thin allowing soft tissue coverage without a bulky view. This is the first study in the literature using a cervicopectoral flap for closure of a facial gunshot wound. We conclude that in patients with facial gunshot wounds, early reconstruction with a cervicopectoral flap offers a very important alternative.

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“…Hence the prevention and treatment of sepsis has long been a priority for careful management [4]. Even in modern days and in civilian settings, wound contamination is an important issue as it has been shown that bacteria could potentially be transferred to the entrance or exit points and within the wound canal by the projectile itself, by clothing or by other exogenous particles [11,18]. Recent research also shows that tissues located far from the primary wound cavity could also be potentially contaminated by exogenous particles depending on the nature of the projectile (soft point or full metal jacket bullets) being used [46].…”

Section: Wound Contamination and Use Of Antibioticsmentioning

confidence: 99%

“…The timing of the reconstruction is a subject for debate. Some authors favour immediate definitive reconstruction within 24 to 48 hours [27] whilst others opt for an early reconstruction within the first 7 days [18,20,22,24,26,28]. For injuries of the head and neck, free flap transfers (fasciocutaneous, osteocutaneous or musculocutaneous) for the reconstruction of soft tissue and bony injuries have resulted in good outcomes [18,[20][21][22][23][24][25][26][27][28].…”

Section: Definitive Management Of Soft Tissue Injuries and Reconstrucmentioning

confidence: 99%

Management of ballistic soft tissue injuries: a review

Goorah¹,

Hindocha²

2013

IOSR-JDMS

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Early Definitive Bone and Soft-Tissue Reconstruction of Major Gunshot Wounds of the Face

Cited by 139 publications

References 0 publications

Tissue-engineered bone biomimetic to regenerate calvarial critical-sized defects in athymic rats

Tissue-engineered bone biomimetic to regenerate calvarial critical-sized defects in athymic rats

Reconstruction of Facial Gunshot Wound by the Cervicopectoral Flap

Management of ballistic soft tissue injuries: a review

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