H. Behnia et Mhk. Motamedi, RECONSTRUCTION AND REHABILITATION OF SHORT-RANGE, HIGH-VELOCITY GUNSHOT INJURY TO THE LOWER FACE - A CASE-REPORT, Journal of cranio-maxillo-facial surgery, 25(4), 1997, pp. 220-227
War injuries can range from the most minor to the devastating and life
-threatening. Multidisciplinary care is required for successful manage
ment of survivors. In the acute phase, care may involve emergency surg
eons, anaesthetists, neurosurgeons, ophthalmic surgeons, vascular surg
eons and ENT specialists in addition to the oral and maxillofacial sur
geon. Afterwards, definitive treatment of facial hard and soft tissue
gunshot injuries depends ultimately on the abilities and skills of the
oral and maxillofacial surgeon and his appreciation of such injuries.
The timing and sequence of the surgical procedures used for reconstru
ction and rehabilitation of maxillofacial gunshot injuries are crucial
to a successful outcome and aesthetic result. If incorrect, they may
lead indefinitely to infection, graft rejection, wound dehiscence with
consequent multiple revisional operations and complications which wil
l prolong hospital stay, and increase treatment costs and morbidity in
these patients. In this article, we describe the treatment protocol f
or reconstruction and rehabilitation of a typical case of devastating
gunshot injury to the lower face and propose a staged sequence of surg
ical treatment based on an 8-year experience gained in treating war ca
sualties during the Iraq-Iran war (1980-1988).