Surgical Modalities in Gunshot Wounds of the Face

Abstract

Maxillofacial traumas caused by gunshot wounds may cause quite varied defects. The objective of this study was to evaluate the reconstruction methods in 12 patients with gunshot wound-related mandibular and maxillofacial bony and soft tissue defects. Twelve patients who were operated on for maxillofacial gunshot wounds at our clinic between 2002 and 2012 were included in the study. Seven patients were wounded in a suicide attempt, and 5 were wounded as a result of an accident or in assaults. Two patients underwent reconstruction using free fibula osteocutaneous flap, 4 patients received the free radial forearm osteocutaneous flap, 2 patients received costal bone graft, and 3 patients received iliac bone grafts. Satisfactory functional and aesthetic outcomes were achieved in cases where staged secondary reconstruction, balloon treatment, and consecutive fat and steroid injections into the depressed scar areas were applied. In conclusion, the basic goal in maxillofacial reconstruction is the functional and aesthetic reconstruction of the contours. Because it is not easy to get perfect results with only 1 clinical approach or 1 method, the proper timing and reconstruction method should be selected.

Late Oropharyngeal Functional Outcomes of Suicidal Maxillofacial Gunshot Wounds

“…9,12,13 The results of reconstructive procedures of 14 cases with gunshot-wounded faces caused by rifle fire were presented by Yuksel et al 13 More recently, Firat and Geyik 9 evaluated the reconstruction methods in 12 patients with gunshot wound-related mandibular and maxillofacial bony and soft tissue defects. Despite the severity of the injuries, all authors achieved acceptable cosmetic results.…”

“…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.…”

Facial Gunshot Wounds

“…15,26 Additional vascularized bone flap options include the radius, scapula, and ilium. 27 Osteogenic distraction may be an additional option for large mandibular defects. 11,28,29 This method has the ability to simultaneously expand the volume of bone, gingiva, soft tissue, and the neurovascular supply.…”

High-Energy Traumatic Maxillofacial Injury

“…3,[12][13][14][15] From our experience, more aggressive surgical debridement is warranted in severe patients with significant energy transference to the facial skeleton. Fragments of bone that reveal acceptable soft tissue support and vitality are carefully preserved during the reduction and fixation of fractures.…”