Characteristics of maxillofacial injuries and safety of in-theater facial fracture repair in severe combat trauma.
The study objectives were to characterize maxillofacial injuries and assess the safety of in-theater facial fracture repair in U.S. military personnel with severe combat trauma from Iraq and Afghanistan. We performed a retrospective chart review of the Expeditionary Medical Encounter Database from 2004 to 2010. 1,345 military personnel with combat-related maxillofacial injuries were identified. Injury severity was quantified with the Abbreviated Injury Scale and Injury Severity Score. Service members with maxillofacial injury and severe combat trauma (Injury Severity Score ≥ 16) were included. The distribution of facial fractures, types, and outcomes of surgical repairs, incidence of traumatic brain injury, concomitant head and neck injuries, burn rate/severity, and rates of Acinetobacter baumannii colonization and surgical site infection were analyzed. The prevalence of maxillofacial injury in the Expeditionary Medical Encounter Database was 22.7%. The most common mechanism of injury was improvised explosive device (65.7%). Midface trauma and facial burns were common. Approximately 64% of the study sample sustained traumatic brain injury. Overall, 45.6% (109/239) had at least one facial bone fracture. Of those with facial fractures, 64.2% (n = 70) underwent surgical repair. None of the service members who underwent in-theater facial fracture repair developed A. baumannii facial wound infection or implant extrusion.
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center San Diego, San Diego, CA 92134.
Matthew W
MW
Keller
Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, CA 92106.
Peggy P
PP
Han
Medical Modeling, Simulation, and Mission Support Department, Naval Health Research Center, San Diego, CA 92106.
Michael R
MR
Galarneau
Department of Otolaryngology-Head and Neck Surgery, Naval Medical Center San Diego, San Diego, CA 92134.
Curtis W
CW
Gaball
D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000453:epidemiology / Q000209:etiology; D002056:Burns / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005151:Facial Injuries / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D008297:Male; D008446:Maxillofacial Injuries / Q000453:epidemiology* / Q000209:etiology / Q000601:surgery*; D008889:Military Personnel / Q000706:statistics & numerical data*; D019647:Oral Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D000067398:War-Related Injuries / Q000453:epidemiology* / Q000601:surgery*