title: Management of maxillofacial injuries in bear mauling cases: a review of 20 cases.
abstract: OBJECTIVE
  As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred.
  
  
  METHODS
  Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications.
  
  
  RESULTS
  Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment.
  
  
  CONCLUSIONS
  Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, India.
authors.forename: Indu Bhusan
authors.identifier: 0000-0002-6524-9240
authors.initials: IB
authors.lastname: Kar
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, India.
authors.forename: Prashant Dilip
authors.identifier: 0000-0002-9792-8862
authors.initials: PD
authors.lastname: Chopda
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, India.
authors.forename: Niranjan
authors.identifier: 0000-0003-0783-5302
authors.initials: N
authors.lastname: Mishra
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, India.
authors.forename: Alok Kumar
authors.identifier: 0000-0003-1303-8369
authors.initials: AK
authors.lastname: Sethi
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, India.
authors.forename: Bikas Ranjan
authors.identifier: 0000-0001-5106-5662
authors.initials: BR
authors.lastname: Mahavoi
keywords: Bear; Free tissue flaps; Maxillofacial injuries; Reconstructive surgical procedures