Facial Trauma: Difference between revisions

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It is important to be aware that a number of patients who suffer trauma to the upper regions of the face also suffer from brain injury<ref name=":0">Perry M (March 2008). "Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? Part 1: dilemmas in the management of the multiply injured patient with coexisting facial injuries". ''International Journal of Oral and Maxillofacial Surgery''. '''37''' (3): 209–14</ref>, and some have co-existing cervical spine injury<ref name=":0" />.
It is important to be aware that a number of patients who suffer trauma to the upper regions of the face also suffer from brain injury<ref name=":0">Perry M (March 2008). "Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? Part 1: dilemmas in the management of the multiply injured patient with coexisting facial injuries". ''International Journal of Oral and Maxillofacial Surgery''. '''37''' (3): 209–14</ref>, and some have co-existing cervical spine injury<ref name=":0" />.


Initial repair following serious facial trauma is performed by surgeons; fractured bones will be plated or wired, skin and soft tissue lacerations will be stitched, large areas of severe soft tissue damage may require grafting<ref>James D. Kretlow, Aisha J. McKnight, Shayan A. Izaddoost.  
Initial repair following serious facial trauma is performed by surgeons; fractured bones will be plated or wired, skin and soft tissue lacerations will be stitched, large areas of severe soft tissue damage may require grafting<ref name=":1">Aveta A, Casati P.  


Soft tissue injuries of the face: early aesthetic reconstruction in polytrauma patients. 
Ann Ital Chir. 2008;79:415–417
</ref><ref name=":1" /><ref>James D. Kretlow, Aisha J. McKnight, Shayan A. Izaddoost.
"Facial Soft Tissue Trauma"
"Facial Soft Tissue Trauma"
Semin Plast Surg. 2010 Nov; 24(4): 348–356
Semin Plast Surg. 2010 Nov; 24(4): 348–356
</ref>.  
</ref>.  

Revision as of 20:28, 11 October 2020

Introduction[edit | edit source]

Trauma to the face and head can be caused by a number of events: explosions, gunshot, road traffic accidents, falling masonry, flying glass, etc.

There can be bony damage - fractures in any of the bones of the head and face, but particularly common in the mandible and nose - and also soft tissue injury. CT scanning is essential as this shows fractures of facial bones more reliably than plain X-ray, and also shows soft tissue injury[1]. Facial and head trauma can also cause damage to the Facial Nerve or the Trigeminal Nerve.

It is important to be aware that a number of patients who suffer trauma to the upper regions of the face also suffer from brain injury[2], and some have co-existing cervical spine injury[2].

Initial repair following serious facial trauma is performed by surgeons; fractured bones will be plated or wired, skin and soft tissue lacerations will be stitched, large areas of severe soft tissue damage may require grafting[3][3][4].

The physiotherapy rehabilitation of these patients is thus largely post operative rehabilitation.

Initial Stages[edit | edit source]

The face has a very rich blood supply, so healing is usually rapid.

Soft Tissue Injury[edit | edit source]

In areas of thin skin (eg. the eyelids) sutures can normally be removed after just 3-4 days, and elsewhere on the face they are often removed after 6 days[5]. Sutures in cartilage, for example the ear or the nose, are often left in situ for 10-14 days.

Bony Injury[edit | edit source]

Surgical repair is often required for bony injury, which may involve wiring or plating, or more substantial surgical techniques to rebuild the damaged bone, such as bone grafting.[2]

Later Stages[edit | edit source]

Resources[edit | edit source]

  • bulleted list
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  1. numbered list
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References[edit | edit source]

  1. Jordan JR, Calhoun KH (2006). "Management of soft tissue trauma and auricular trauma". In Bailey BJ, Johnson JT, Newlands SD, et al. (eds.). Head & Neck Surgery: Otolaryngology. Hagerstwon, MD: Lippincott Williams & Wilkins. pp. 935–36.
  2. 2.0 2.1 2.2 Perry M (March 2008). "Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? Part 1: dilemmas in the management of the multiply injured patient with coexisting facial injuries". International Journal of Oral and Maxillofacial Surgery37 (3): 209–14
  3. 3.0 3.1 Aveta A, Casati P. Soft tissue injuries of the face: early aesthetic reconstruction in polytrauma patients.  Ann Ital Chir. 2008;79:415–417
  4. James D. Kretlow, Aisha J. McKnight, Shayan A. Izaddoost. "Facial Soft Tissue Trauma" Semin Plast Surg. 2010 Nov; 24(4): 348–356
  5. Ardeshirpour F, Shaye DA, Hilger PA. Improving posttraumatic facial scars. Otolaryngol Clin North Am. 2013 Oct. 46(5):867-8