Facial gunshot wounds: a 4-year experience.
OBJECTIVE
Facial gunshot wounds can result in devastating functional and aesthetic consequences for patients. In an attempt to evaluate the management and outcome in these patients, a 4-year retrospective review was undertaken of all patients presenting with facial gunshot wounds at a level I trauma center.


METHODS
A total of 121 patients were identified. Medical documentation could be obtained on 84 of those patients. The patients' maxillofacial injuries were treated by the 3 participating services: plastic surgery, oral and maxillofacial surgery, and otorhinolaryngology. The patients ranged in age from 6 to 64 years, with a mean age of 27 years.


RESULTS
The gunshot wounds were single in 64% of the cases and multiple in 36% of the cases. Overall mortality in the series was 11%. Sixty-seven percent (56/84) of the patients suffered an injury to the underlying craniofacial skeleton. Seventy-five percent of these patients required surgical intervention. Twenty-one percent of the patients (16/75) required tracheostomy emergently for management of the airway. Eighteen percent (15/84) of these patients had an intracranial injury, with 50% of these patients requiring surgery. Fourteen percent of the patients in the series (12/84) had great vessel injuries diagnosed at the time of angiography, with 50% of these patients requiring surgery for treatment.


CONCLUSIONS
Contrary to much of the published literature, most patients in this series required surgical intervention for treatment of their facial gunshot wounds. Reconstructive procedures were performed early in the patient's course and, when possible, addressed both the soft tissue and underlying bony injury in a minimum number of stages.
Division of Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, TX 77030, USA. Lhollier@aol.com
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Grantcharova
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Kattash
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001930:Brain Injuries / Q000145:classification / Q000601:surgery; D002648:Child; D015807:Eye Injuries, Penetrating / Q000145:classification / Q000601:surgery; D005147:Facial Bones / Q000293:injuries; D005151:Facial Injuries / Q000145:classification / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008338:Mandibular Injuries / Q000145:classification / Q000601:surgery; D008446:Maxillofacial Injuries / Q000145:classification / Q000601:surgery; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D012886:Skull / Q000293:injuries; D015996:Survival Rate; D014139:Tracheostomy; D014948:Wounds, Gunshot / Q000145:classification / Q000601:surgery*; D015050:Zygoma / Q000293:injuries