Management of maxillofacial injuries in the Iran-Iraq war

Facial injuries in Iranian veterans during the Iraq–Iran war (1980–88): differences from recent conflicts

“…13 Fragmentation injuries were the most common in Iranian veterans during the Iraq-Iran conflict, which confirms the study by Sadda who reported that fragmentation was responsible for 80% of maxillofacial injuries, followed by bullets (19.7%). 14 Bullets and fragments of mortar shells were the most common causes of maxillofacial injuries in the Iraq-Iran conflict according to Akhlaghi and AframianFarnad, 15 and Will et al reported that half the maxillofacial injuries in Iraq were caused by fragmentation after detonation of improvised explosive devices, 16 which is in agreement with the study by Breeze et al about the Iraq and Afghanistan conflicts. 17 Explosive injuries were also responsible for many craniomaxillofacial injuries.…”

“…22 The use of helmets, face shields, or protective glasses has been recommended by Akhlaghi and Afranian-Farnad for reducing the amount and effect of head and facial trauma. 15 It has been mentioned that personal protective equipment could protect infantry soldiers against fragmentation injurieswhich were the major cause of facial injuries in our study -and that current items of protective clothing protect the eyes but not the remaining face. 17 It should be mentioned that a simple helmet was the only protection that most of the Iranian veterans had during the Iraq-Iran conflict, which reflects the large number of facial (and particular mandibular) injuries.…”

Prevention of Infections Associated With Combat-Related Eye, Maxillofacial, and Neck Injuries

“…14,15 In the Balkans, conflict wounds became infected postoperatively in 19% of war-wounded patients, 16 and in the Iran-Iraq war, 11% of maxillofacial injuries were complicated by infection. 17 Two small case series from the Iraq war of patients undergoing open reduction and internal fixation of fractures at Role 3 (e.g., combat support hospital) described a 0% infection rate among 17 patients; 18 however, a second review of 130 patients described a 24% infection rate. 19 Actual pathogen descriptions of maxillofacial infections in combat-associated wounds are limited and include Klebsiella spp., and fungi (likely Candida spp.…”

“…21 Perioperative ampicillin or penicillin 17 have also been used. We previously concluded these agents might have utility.…”

Prevention and Management of Infections Associated With Combat-Related Head and Neck Injuries

“…20 The mandible, especially the anterior, was the most prominent area injured. Twenty-four cases (11%) were complicated by infection, including nine cases of osteomyelitis.…”