TY - JOUR
T1 - Evidence-Based Medicine for Ballistic Maxillofacial Trauma
AU - Wamkpah, Nneoma S.
AU - Kimball, Abby
AU - Pipkorn, Patrik
N1 - Publisher Copyright:
© 2023 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2023/5/10
Y1 - 2023/5/10
N2 - Ballistic trauma is a serious health issue with significant costs to physical, psychosocial, economic, and societal well-being. It may be caused from firearms, explosive devices, or any other projectile forces, and is characterized by severe tissue loss and evolving tissue devitalization. This review covers mechanism, diagnosis, and management of ballistic maxillofacial trauma, specifically. Initial evaluation includes stabilization of airway, bleeding, and circulation, followed by assessment of other injuries. The overall degree of tissue damage is determined by intrinsic patient factors and extrinsic projectile factors. Management of ballistic injuries has shifted toward advocation for early operative repair with the advent of antibiotics and advanced techniques in maxillofacial reconstruction. Appropriate timing and method of reconstruction should be carefully selected on a case-by-case basis. While ballistic trauma research is limited to studies biased by institutional practices, areas for further study identified from current literature include guidelines directing timing of reconstructive surgery; thresholds for free tissue transfer; handling of retained projectiles; incidence of surgical complications; and clinical outcomes for computer-aided surgical repair of these highly destructive injuries.
AB - Ballistic trauma is a serious health issue with significant costs to physical, psychosocial, economic, and societal well-being. It may be caused from firearms, explosive devices, or any other projectile forces, and is characterized by severe tissue loss and evolving tissue devitalization. This review covers mechanism, diagnosis, and management of ballistic maxillofacial trauma, specifically. Initial evaluation includes stabilization of airway, bleeding, and circulation, followed by assessment of other injuries. The overall degree of tissue damage is determined by intrinsic patient factors and extrinsic projectile factors. Management of ballistic injuries has shifted toward advocation for early operative repair with the advent of antibiotics and advanced techniques in maxillofacial reconstruction. Appropriate timing and method of reconstruction should be carefully selected on a case-by-case basis. While ballistic trauma research is limited to studies biased by institutional practices, areas for further study identified from current literature include guidelines directing timing of reconstructive surgery; thresholds for free tissue transfer; handling of retained projectiles; incidence of surgical complications; and clinical outcomes for computer-aided surgical repair of these highly destructive injuries.
KW - ballistic
KW - facial injuries
KW - free tissue transfer
KW - gunshot wounds
KW - maxillofacial trauma
KW - projectile
UR - http://www.scopus.com/inward/record.url?scp=85159484674&partnerID=8YFLogxK
U2 - 10.1055/s-0043-1764347
DO - 10.1055/s-0043-1764347
M3 - Article
C2 - 36929067
AN - SCOPUS:85159484674
SN - 0736-6825
VL - 39
SP - 237
EP - 252
JO - Facial Plastic Surgery
JF - Facial Plastic Surgery
IS - 3
ER -