Definitive Management of Ballistic and High Energy Facial Trauma — The Association Specialists

Definitive Management of Ballistic and High Energy Facial Trauma (#38)

Neal Futran 1
  1. University of Washington, Seattle, WA, United States

Management of ballistic injuries to the head and neck begins withadvanced trauma life support protocols. Treatment of severe facialtrauma requires early tissue debridement with bony repair and/orstenting to minimize scar contracture The initial operation also aims toestablish occlusion, stabilize bone and close soft tissue defects. Serialdebridement of wounds with delayed reconstruction has given wayto early definitive repair with vascularized tissue. Free tissue transfertechniques allow simultaneous reconstruction of the bony frameworkand overlying tissues This has led to improved function, fewer operations,and shorter hospital stays. Multiple secondary procedures are frequentlyrequired for optimal aesthetic restoration. An aggressive managementalgorithm has been developed to optimize facial form and function:(1) the initial encounter, (2) definitive reconstruction with vascularized tissue, and (3) aesthetic and prosthetic refinement.

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