Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct 1;150(4):835e-846e.
doi: 10.1097/PRS.0000000000009553. Epub 2022 Jul 29.

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multidisciplinary Expert Consensus

Matthew E Pontell  1 , Jordan P Steinberg  1 , Donald R Mackay  1 , Eduardo D Rodriguez  1 , E Bradley Strong  1 , Alexis B Olsson  1 , J David Kriet  1 , Kevin J Kelly  1 , Mark W Ochs  1 , Peter J Taub  1 , Shaun C Desai  1 , Stephen MacLeod  1 , Srinivas Susarla  1 , Travis T Tollefson  1 , Warren Schubert  1 , Brian C Drolet  1 , Michael S Golinko  1
Affiliations

Interfacility Transfer Guidelines for Isolated Facial Trauma: A Multidisciplinary Expert Consensus

Matthew E Pontell et al. Plast Reconstr Surg. .

Abstract

Background: The objective of this study was to develop guidelines for the transfer of patients with isolated craniomaxillofacial trauma.

Methods: A national, multidisciplinary expert panel was assembled from leadership in national organizations and contributors to published literature on facial reconstruction. The final panel consisted of five plastic surgeons, four otolaryngologist-head and neck surgeons, and four oral and maxillofacial surgeons. The expert panelists' opinions on transfer guidelines were collected using the modified Delphi process. Consensus was predefined as 90 percent or greater agreement per statement.

Results: After four Delphi consensus building rounds, 13 transfer guidelines were established, including statements on fractures of the frontal sinus, orbit, midface, and mandible, as well as soft-tissue injuries. Twelve guidelines reached consensus.

Conclusions: The decision to transfer a patient with craniomaxillofacial trauma to another facility is complex and multifactorial. While a percentage of overtriage is acceptable to promote safe disposition of trauma patients, unnecessarily high rates of secondary overtriage divert emergency medical services, increase costs, delay care, overload tertiary trauma centers, and result in tertiary hospital staff providing primary emergency coverage for referring hospitals. These craniomaxillofacial transfer guidelines were designed to serve as a tool to improve and streamline the care of facial trauma patients. Such efforts may decrease the additional health care expenditures associated with secondary overtriage while decompressing emergency medical systems and tertiary emergency departments.

PubMed Disclaimer

Conflict of interest statement

Disclosure : The authors have no relevant disclosures or conflicts of interest to report. No financial support was received for this project.

References

    1. American Trauma Society. Trauma center levels explained. Available at: https://www.amtrauma.org/page/traumalevels . Accessed August 20, 2020.
    1. Pontell M, Mount D, Steinberg JP, Mackay D, Golinko M, Drolet BC. Interfacility transfers for isolated craniomaxillofacial trauma: Perspectives of the facial trauma surgeon. Craniomaxillofac Trauma Reconstr. 2021;14:201–208.
    1. Sasser SM, Hunt RC, Faul M, et al.; Centers for Disease Control and Prevention (CDC). Guidelines for field triage of injured patients: Recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recomm Rep. 2012;61(RR-1):1–20.
    1. Sampalis JS, Denis R, Lavoie A, et al. Trauma care regionalization: A process-outcome evaluation. J Trauma 1999;46:565–579.
    1. Sampalis JS, Denis R, Frechette P, Brown R, Fleiszer D, Mulder D. Direct transport to tertiary trauma centers versus transfer from lower level facilities: Impact on mortality and morbidity among patients with major trauma. J Trauma 1997;43:288–295; discussion 295–296.