Reconstruction of gunshot wounds of the mandible

Taher, Abbas

doi:10.1016/s1010-5182(05)80538-4

Cited by 20 publications

(3 citation statements)

References 14 publications

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“…4 Although existing literature supports immediate debridement and skeletal fixation following blast firearm injuries, the timing and sequence of craniofacial skeletal reconstruction remain controversial. 3–6,8–10 With the evolution of microsurgical techniques, free tissue transfers have become more common in the reconstruction of these complex injuries. However, the ideal technique and timing to minimize complications, optimize restoration of function, and achieve the best aesthetic outcomes are also unclear in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The rarity of this patient presentation has been frequently discussed in the literature. [3][4][5][6] In one multi-institutional study, eight participating trauma centers averaged between one and 20 patients per year with a postpresentation mortality rate of 26%. 7 Although these patients' injuries represent a minority of gunshot wounds (GSWs), their complicated needs require a unique multidisciplinary approach that takes a profound toll on involved health care systems, with costs averaging greater than $100,000 per patient.…”

Section: Introductionmentioning

confidence: 99%

“…reconstruction remain controversial. [3][4][5][6][8][9][10] With the evolution of microsurgical techniques, free tissue transfers have become more common in the reconstruction of these complex injuries. However, the ideal technique and timing to minimize complications, optimize restoration of function, and achieve the best aesthetic outcomes are also unclear in this group of patients.…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive Treatment and Reconstructive Algorithm for Functional Restoration after Ballistic Facial Injury

Chaiyasate

Gupta

Boudiab

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Background: Ballistic facial injuries are rare, with most trauma centers reporting 1-20 cases annually. These patients present significant management challenges to reconstructive surgeons, not only due to their rarity but also due to the complex decision-making process that is involved. The aim of this study was to review our experience with the application of craniofacial microsurgery in management of facial gunshot wounds. Methods: A retrospective review of a single-surgeon experience at a level I trauma center from 2011 to 2020 for patients sustaining self-inflicted gunshot wounds to the face requiring microsurgical reconstruction was performed. Outcomes included reconstructive techniques, free flap type and indication, airway evolution, feeding modality, respective timing of interventions, and complications. Results: Between 2012 and 2021, 13 patients presented for microsurgical reconstruction at our institution for gunshot wounds to the face. The majority (90%) of patients were men, and the average age at time of injury was 26. The median from the time of injury to first free flap was 93 days. Thirteen patients represented 23 free flaps. On average, patients underwent a total of two free flaps. The most common microsurgical flap was the fibula flap ( 14) followed by the radial forearm flap (6). Conclusions: Based on our findings, we describe a novel algorithm for function restoration and aesthetic revisions based on injury location. Underlying principles include avoiding early use of reconstruction plates, establishing occlusion early, and aligning bony segments using external fixation. An algorithmic approach to these injuries can improve outcomes.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comprehensive Treatment and Reconstructive Algorithm for Functional Restoration after Ballistic Facial Injury

Chaiyasate

Gupta

Boudiab

et al. 2022

Plastic and Reconstructive Surgery - Global Open

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Basics of AO/ASIF Principles and Stable Internal Fixation of Mandibular Fractures

Greenberg¹

1993

Craniomaxillofacial Fractures

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Morphology and blood supply of the iliac crest applied to jaw reconstruction

et al. 1997

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The aim of this study was to improve vessel and nerve security and the harvesting procedure of the iliac crest in the microvascular reconstruction of the upper and lower jaw by iliac crest flap in cases of tumour invasion or trauma. The critical points for the surgeon in harvesting the iliac crest are the course of the deep circumflex iliac artery and lateral cutaneous nerve of the thigh in relation to the iliac crest and the position of their subsequent ramifications. Bilateral anatomical preparations of the iliac bone (total 90 dissections) were examined in 45 formalin preserved cadavers (21 male, 24 female) with the course of the vessel and nerve supply being mapped. Topographic variations of muscles, bones, vessels and nerves were documented by measurement by photographic documentation and diagrams. In 78% (70 cases) a standard-type arrangement with a single main vessel coming from the external iliac artery above the inguinal ligament and crossing the upper part of the iliac crest with second ramifications was observed. In 12% (11 cases) the main vessel was observed to be 2-3 cm below the iliac crest, in 7% (6 cases) a second main branch of the deep circumflex iliac artery was found to run parallel to the iliac crest. In other cases the following variations were observed: one main vessel without ramification, separate branching of the main vessel and ramifications or common trunks of the deep and superficial circumflex iliac arteries. Because of these results it might be possible to perform window resection of the iliac crest in some cases rather than bloc resection: this may have postoperative advantages for the patient.

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Reconstruction of gunshot wounds of the mandible

Cited by 20 publications

References 14 publications

Comprehensive Treatment and Reconstructive Algorithm for Functional Restoration after Ballistic Facial Injury

Comprehensive Treatment and Reconstructive Algorithm for Functional Restoration after Ballistic Facial Injury

Basics of AO/ASIF Principles and Stable Internal Fixation of Mandibular Fractures

Morphology and blood supply of the iliac crest applied to jaw reconstruction

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