Complicated Facial Lacerations: Challenges in the Repair and Management of Complications by a Facial Trauma Team.

IF 0.8 Q4 DENTISTRY, ORAL SURGERY & MEDICINE Craniomaxillofacial Trauma & Reconstruction Pub Date : 2023-03-01 Epub Date: 2022-02-01 DOI:10.1177/19433875211064512
Moumita De, Sushma Sagar, Aniket Dave, Ruchi Pathak Kaul, Maneesh Singhal
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Abstract

Study Design: This is a descriptive study where we present our experience in managing complicated facial wounds over a period of 1 year at a level 1 trauma centre by a dedicated facial trauma team consisting of a plastic surgeon, a trauma surgeon and a Maxillofacial surgeon. Objective: Facial deformities have profound impact on the social and psychological aspect of a person's life. Hence, management of facial wounds is very crucial. Most of the facial injuries are usually managed by emergency care physician and emergency surgeon. But certain wounds require specialised knowledge and care due to their complicated nature. The objective of this paper is to highlight those special types of wounds and the challenges they pose. It also aims to enumerate the best possible management according to each situation in a protocol-based manner, which will help in decision making by the attending emergency physician/surgeon. Methods: Facial lacerations were designated as "complicated" according to some pre-defined features and pre, intra and post operative data and photographs were collected by interviewing the concerned surgical team. The data were analysed and presented as different clinical scenarios. Results: The cases were broadly grouped under 6 scenarios according to the unique combination of difficulties faced and their specific management. The challenges faced were enumerated and the steps undertaken were also mentioned against them. Lastly, the scenarios were compared with available literature to find out the best possible management in each situation and to present them in a protocol-based manner. Conclusion: Protocol-based management of injuries to the different parts and specialised structures of the face is extremely helpful. Role of a specialised facial trauma team also should be emphasised in complicated facial injuries.

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复杂的面部撕裂伤:面部创伤团队在修复和处理并发症方面面临的挑战。
研究设计:这是一项描述性研究,我们将介绍由整形外科医生、创伤外科医生和颌面外科医生组成的面部创伤专业团队在 1 级创伤中心处理复杂面部伤口的 1 年经验。目的:面部畸形对个人生活的社交和心理方面有着深远的影响。因此,面部创伤的处理非常关键。大多数面部创伤通常由急诊内科医生和急诊外科医生处理。但某些伤口由于其复杂性,需要专业的知识和护理。本文旨在强调这些特殊类型的伤口及其带来的挑战。本文还旨在以协议为基础,根据每种情况列举出可能的最佳处理方法,这将有助于急诊主治医师/外科医生做出决策。方法:根据一些预先确定的特征将面部裂伤定为 "复杂",并通过采访相关手术团队收集术前、术中和术后数据及照片。对数据进行分析,并以不同的临床场景呈现。结果:根据所面临困难的独特组合及其具体处理方法,病例大致分为 6 种情况。我们列举了所面临的挑战,并提到了针对这些挑战所采取的措施。最后,将这些情景与现有文献进行比较,以找出每种情况下的最佳处理方法,并以规程为基础将其呈现出来。结论对面部不同部位和特殊结构的损伤进行基于规程的处理非常有帮助。对于复杂的面部损伤,也应强调面部创伤专业团队的作用。
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Craniomaxillofacial Trauma & Reconstruction
Craniomaxillofacial Trauma & Reconstruction DENTISTRY, ORAL SURGERY & MEDICINE-
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