[Maxillofacial gunshot injuries in hostility activities in 2000-2003]

Abstract

The management of facial gunshot wounded patients requires the coordination of multiple surgical disciplines to optimize the functional and cosmetic outcome while minimizing overall morbidity and mortality. All reports indicate that early management of these patients must focus on the basis of resuscitation, with major attention given to the status of maintaining the airway, hemostasis and hemodynamic resuscitation. Subsequent management of these patients becomes more controversial in terms of surgical reconstruction: immediate or delayed. Involvement of the use of suicide bombers, the type of weapons used in the last 2 years were different than previously described. The injuries were inflicted by explosives mixed with nails bolts and stones, which caused different kinds of wounds ever described. Numerous series in the literature advocate early aggressive intervention of one-stage reconstruction of all involved structures. However, several series published in the literature favor a more conservative approach, some of them even advocating non-operative management of these injuries. We concluded that a delay in final reconstruction of facial fractures in the critically ill patient has an acceptably low complication rate and may be advantageous in decreasing operative risk. A carefully planned reconstruction schedule is required to achieve satisfactory function and appearance. It is our purpose in this report to indicate the difference of the gunshot wounds in the last 2 years of the hostilities in this part of the world and emphasize the function of the Oral & Maxillofacial Surgeons in treating these patients.