Walk-through injuries: Glass door facial injuries

During 1998, 13 patients were treated in the Tel-Aviv Sourasky Medical Cent er for complex facial soft-tissue injuries caused by passing through large, clear glass doors. All epidemiological details were gathered and analyzed. Of 1,100 soft-tissue facial injury admissions in 1 year, 13 patients had a substantial soft-tissue facial injury after passing through a glass barrie r. Nine were injured during leisure time activity, five in a shopping mall, and four in their residence. Interestingly, the authors found a common pat tern of facial injuries in all patients. It consisted of large, irregular, composite skin and soft-tissue flaps as well as large, torn, irregular skin lacerations. The nose was injured predominantly, and the injury was partic ularly complex, Their recommended management of these injuries is a thoroug h and careful evaluation of flap viability, Surgical management of avulsed, viable flaps includes margin debridement and repositioning. If the flap is narrow enough, it can be debrided and the margins adapted primarily. If vi ability of part of the flap is in doubt, that part should be debrided and u sed as a composite graft. When this graft dies, a full-thickness graft is t aken from another facial site. The cosmesis of such a graft is better than using the debrided, thin segment as a skin graft that is too thin. The auth ors emphasize that there is a need to encourage authorities to reinforce re gulations relating to injury prevention from architectural glass. The first is to use special glazing, either tempered glass, laminated glass, or both . The other method of improving safety is by indicating glass using decorat ions or warning stickers, or by making it partly translucent. Unless these regulations are obeyed, fatal or complex trauma may occur.