Updates in Management of Craniomaxillofacial Gunshot Wounds and Reconstruction of the Mandible

Khatib, Baber; Gelesko, Savannah; Amundson, Melissa; Cheng, Allen; Patel, Ashish; Bui, Tuan; Dierks, Eric J.; Bell, R. Bryan

doi:10.1016/j.fsc.2017.06.007

Cited by 25 publications

(23 citation statements)

References 53 publications

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“…2). 18 Virtual surgery allows manipulation of digital prototypes to restore anatomical structures. The creation of stereolithographic models further assists in designing custom cutting guides, plates, and implants.…”

Section: Surgical Planningmentioning

confidence: 99%

“…The creation of stereolithographic models further assists in designing custom cutting guides, plates, and implants. 11,18 New manufacturing processing allows for custom-formed plates to minimize operative bending and manipulations. VSP can also incorporate data from stock donor sites or patient-specific donor locations to incorporate autologous tissue reconstruction.…”

Section: Surgical Planningmentioning

confidence: 99%

“…VSP continues to evolve into common practice and much has been published about its success. [17][18][19][20] Operative Principles…”

Section: Surgical Planningmentioning

confidence: 99%

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Facial Gunshot Wounds

et al. 2019

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Craniomaxillofacial gunshot injuries, resulting from assault, suicide attempts, and accidental trauma, represent a major public health dilemma in the United States. Due to the extent of injury and resulting osseous and soft tissue loss, facial gunshot wounds pose a unique challenge to the reconstructive surgeon. Initial management should use advanced trauma life support principles with the goal of patient stabilization. Acute operative management should center around wound decontamination, debridement, and temporary closure. Historically, definitive surgical management focused on delayed reconstruction secondary to high rates of wound infections, necrosis, and ischemia. With improvements in imaging modalities, the advent of virtual surgical planning, and the popularization of microvascular free flaps, contemporary methods have shifted toward earlier more definitive reconstruction. Autologous free tissue transfer has resulted in a decrease in hospital stay and the number of overall surgeries. Importantly, due to the variability in injury pattern and complexity in reconstruction, a systematic approach toward intervention is needed to mitigate complications and optimize overall functional and aesthetic outcomes.

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Section: Surgical Planningmentioning

confidence: 99%

Section: Surgical Planningmentioning

confidence: 99%

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Facial Gunshot Wounds

et al. 2019

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“…59 Flap options beyond the fibula include the deep circumflex iliac artery, scapula, and osteocutaneous radial forearm free flap. 60 Fixation of these neomandibles can occur through multiple mini plates or a single reconstructive plate. While some groups have found no difference in outcomes between the two techniques, 61 others have found that mini plates required removal for infection more frequently.…”

Section: Gunshot Woundsmentioning

confidence: 99%

“…63 The use of computer-aided design, computer-aided manufacturing, virtual surgical planning, stereolithic models, custom plates, intraoperative navigation, and intraoperative imaging all represent technological advances that are gradually being implemented more frequently in complex mandible reconstructions. 60 These advances are leading to decreased operative times, decreased costs, and better functional and aesthetic outcomes. 60…”

Section: Gunshot Woundsmentioning

confidence: 99%

Management of Complex Mandible Fractures

et al. 2019

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Mandible fractures represent a common sequela of craniomaxillofacial trauma encountered by reconstructive surgeons. Management of complex mandibular fractures, and reestablishment of the occlusal relationship, represents a challenging reconstructive endeavor for even the most skilled surgeon. In this article, the authors review the treatment options for particularly complex presentations of this injury pattern.

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