Facial Trauma
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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]
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References[edit | edit source]
- ↑ 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.
- ↑ 2.0 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 Surgery. 37 (3): 209–14
- ↑ 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
- ↑ James D. Kretlow, Aisha J. McKnight, Shayan A. Izaddoost. "Facial Soft Tissue Trauma" Semin Plast Surg. 2010 Nov; 24(4): 348–356
- ↑ Ardeshirpour F, Shaye DA, Hilger PA. Improving posttraumatic facial scars. Otolaryngol Clin North Am. 2013 Oct. 46(5):867-8
