The role of the maxillofacial surgeon in the initial 48h following a terrorist attack

Patterns of maxillofacial injuries caused by terrorist attacks in Iraq: retrospective study

“…Most maxillofacial trauma results from the secondary and tertiary effects of the blast. This study showed variation in the severity of injuries according to the four mechanisms of blast injuries, modified by the magnitude of the explosion, the environment (open or enclosed space), collapse of buildings and the distance between the victim and the explosion 6,8 . This explains why the victims presented a wide range of injuries, involving one or more area of the face, varying from simple abrasion to severe multiple, penetrating, lacerating or avulsed injuries associated with fractures.…”

“…In addition to conventional war, the rise of terrorism has added another dimension to the potential for warlike injuries 1 . Other researchers have discussed the injuries caused by terrorism as a separate type of intentional injury 6,15 . The incidence of maxillofacial terrorrelated casualties is high 15 , but there are few studies about this type of injury.…”

“…Improvements in the explosive devices made by the terrorists means they are capable of producing mass casualties because their activities are directed towards crowded places. Their bomb blasts produce multidimensional injuries, modified by the amount and type of explosive, the nature of the environment and the people involved 6 . In addition to conventional war, the rise of terrorism has added another dimension to the potential for warlike injuries 1 .…”

Blast Injuries

“…Up to 10% of all surviving blast victims are thought to have notable ocular injuries (12). Those seen most frequently are intraocular foreign bodies, corneal abrasions, lacerations of the lid or periorbital region, retinal detachment, orbital fractures, and globe rupture (1,(61)(62)(63).…”

“…When blast-related cardiac dysfunction is suspected, inotropic support should be provided in lieu of overly aggressive fluid infusion, as associated lung injury is common (62).…”