Management of maxillofacial problems in self-inflicted rifle wounds
Severe gunshot wounds to the face, produced by high-velocity rifles or shotgun blasts, present a formidable challenge to reconstructive surgeons. In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those...
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| Veröffentlicht in: | Annals of plastic surgery 2004-08, Vol.53 (2), p.111-117 |
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| creator | YUKSEL, Fuat CELIKOZ, Bahattin ERGUN, Ozge PEKER, Fatih ACIKEL, Cengiz EBRINC, Servet |
| description | Severe gunshot wounds to the face, produced by high-velocity rifles or shotgun blasts, present a formidable challenge to reconstructive surgeons. In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those victims were determined. These patients had attempted to commit suicide and placed the muzzles of the rifles beneath their chins. The ages of the patients ranged from 20 to 24 years, with a mean age of 22 years. These wounds were caused by close-range gunshots ( |
| doi_str_mv | 10.1097/01.sap.0000116304.70332.26 |
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In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those victims were determined. These patients had attempted to commit suicide and placed the muzzles of the rifles beneath their chins. The ages of the patients ranged from 20 to 24 years, with a mean age of 22 years. These wounds were caused by close-range gunshots (<10 cm), and the missiles had high velocity (more than 800 m/second). All patients had wounds in their submental triangle areas. The exit sites of the missiles differed among patients. All exit wounds were in the angle limited by the deviation from the gun-barrel axis. After clinical and radiologic evaluation and conservative debridement of all devitalized tissues, the fractures were reduced and stabilized appropriately. Large bony defects were treated by bone grafting, and all soft tissue lesions were closed in layers. The entrance and exit sites were covered primarily after thorough debridement except one case whose defect was reconstructed with bilateral sternocleidomastoid (SCM) flaps, one for submental skin and the other for the mouth floor. Intraoral soft tissues were then repaired by primary closure, tongue flaps, or SCM flaps in case they were necessary. Free tissue transfers were not required for treatment of secondary soft-tissue problems. Resolution of tissue edema, softening of scars in time, and insertion of bone graft may improve the deformity significantly. The initial anatomic reconstruction of the existing bone skeleton and the maximal use of regional tissue for cutaneous reconstruction provide an esthetic appearance that can never be duplicated by secondary reconstruction.</description><identifier>ISSN: 0148-7043</identifier><identifier>EISSN: 1536-3708</identifier><identifier>DOI: 10.1097/01.sap.0000116304.70332.26</identifier><identifier>PMID: 15269577</identifier><identifier>CODEN: APCSD4</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Biological and medical sciences ; Debridement ; Facial Injuries - surgery ; Humans ; Mandibular Injuries - surgery ; Maxilla - injuries ; Medical sciences ; Reconstructive Surgical Procedures ; Soft Tissue Injuries - surgery ; Suicide, Attempted ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Wounds, Gunshot - surgery</subject><ispartof>Annals of plastic surgery, 2004-08, Vol.53 (2), p.111-117</ispartof><rights>2004 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c345t-a2288b2eadcdf57e7a2793c4117a6f868848c13ac8c6f3fd975ba24af05f61b03</citedby><cites>FETCH-LOGICAL-c345t-a2288b2eadcdf57e7a2793c4117a6f868848c13ac8c6f3fd975ba24af05f61b03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15978853$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15269577$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>YUKSEL, Fuat</creatorcontrib><creatorcontrib>CELIKOZ, Bahattin</creatorcontrib><creatorcontrib>ERGUN, Ozge</creatorcontrib><creatorcontrib>PEKER, Fatih</creatorcontrib><creatorcontrib>ACIKEL, Cengiz</creatorcontrib><creatorcontrib>EBRINC, Servet</creatorcontrib><title>Management of maxillofacial problems in self-inflicted rifle wounds</title><title>Annals of plastic surgery</title><addtitle>Ann Plast Surg</addtitle><description>Severe gunshot wounds to the face, produced by high-velocity rifles or shotgun blasts, present a formidable challenge to reconstructive surgeons. In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those victims were determined. These patients had attempted to commit suicide and placed the muzzles of the rifles beneath their chins. The ages of the patients ranged from 20 to 24 years, with a mean age of 22 years. These wounds were caused by close-range gunshots (<10 cm), and the missiles had high velocity (more than 800 m/second). All patients had wounds in their submental triangle areas. The exit sites of the missiles differed among patients. All exit wounds were in the angle limited by the deviation from the gun-barrel axis. After clinical and radiologic evaluation and conservative debridement of all devitalized tissues, the fractures were reduced and stabilized appropriately. Large bony defects were treated by bone grafting, and all soft tissue lesions were closed in layers. The entrance and exit sites were covered primarily after thorough debridement except one case whose defect was reconstructed with bilateral sternocleidomastoid (SCM) flaps, one for submental skin and the other for the mouth floor. Intraoral soft tissues were then repaired by primary closure, tongue flaps, or SCM flaps in case they were necessary. Free tissue transfers were not required for treatment of secondary soft-tissue problems. Resolution of tissue edema, softening of scars in time, and insertion of bone graft may improve the deformity significantly. The initial anatomic reconstruction of the existing bone skeleton and the maximal use of regional tissue for cutaneous reconstruction provide an esthetic appearance that can never be duplicated by secondary reconstruction.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Debridement</subject><subject>Facial Injuries - surgery</subject><subject>Humans</subject><subject>Mandibular Injuries - surgery</subject><subject>Maxilla - injuries</subject><subject>Medical sciences</subject><subject>Reconstructive Surgical Procedures</subject><subject>Soft Tissue Injuries - surgery</subject><subject>Suicide, Attempted</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Wounds, Gunshot - surgery</subject><issn>0148-7043</issn><issn>1536-3708</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkE1LxDAQhoMo7rr6F6QIemvNd1JvsvgFK170HKZpIpG0XZsW9d9b3YLOZS7P-87wIHRGcEFwqS4xKRJsCzwNIZJhXijMGC2o3ENLIpjMmcJ6Hy0x4TpXmLMFOkrpbcKp5vIQLYigshRKLdH6EVp4dY1rh6zzWQOfIcbOgw0Qs23fVdE1KQttllz0eWh9DHZwddYHH1320Y1tnY7RgYeY3Mm8V-jl9uZ5fZ9vnu4e1teb3DIuhhwo1bqiDmpbe6GcAqpKZjkhCqTXUmuuLWFgtZWe-bpUogLKwWPhJakwW6GLXe_01_vo0mCakKyLEVrXjclIqWhZUjGBVzvQ9l1KvfNm24cG-i9DsPlRaDAxk0Lzp9D8KjRUTuHT-cpYNa7-i87OJuB8BiBZiL6H1ob0jyuV1oKxb90GexI</recordid><startdate>20040801</startdate><enddate>20040801</enddate><creator>YUKSEL, Fuat</creator><creator>CELIKOZ, Bahattin</creator><creator>ERGUN, Ozge</creator><creator>PEKER, Fatih</creator><creator>ACIKEL, Cengiz</creator><creator>EBRINC, Servet</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20040801</creationdate><title>Management of maxillofacial problems in self-inflicted rifle wounds</title><author>YUKSEL, Fuat ; CELIKOZ, Bahattin ; ERGUN, Ozge ; PEKER, Fatih ; ACIKEL, Cengiz ; EBRINC, Servet</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c345t-a2288b2eadcdf57e7a2793c4117a6f868848c13ac8c6f3fd975ba24af05f61b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Debridement</topic><topic>Facial Injuries - surgery</topic><topic>Humans</topic><topic>Mandibular Injuries - surgery</topic><topic>Maxilla - injuries</topic><topic>Medical sciences</topic><topic>Reconstructive Surgical Procedures</topic><topic>Soft Tissue Injuries - surgery</topic><topic>Suicide, Attempted</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Wounds, Gunshot - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>YUKSEL, Fuat</creatorcontrib><creatorcontrib>CELIKOZ, Bahattin</creatorcontrib><creatorcontrib>ERGUN, Ozge</creatorcontrib><creatorcontrib>PEKER, Fatih</creatorcontrib><creatorcontrib>ACIKEL, Cengiz</creatorcontrib><creatorcontrib>EBRINC, Servet</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of plastic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>YUKSEL, Fuat</au><au>CELIKOZ, Bahattin</au><au>ERGUN, Ozge</au><au>PEKER, Fatih</au><au>ACIKEL, Cengiz</au><au>EBRINC, Servet</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of maxillofacial problems in self-inflicted rifle wounds</atitle><jtitle>Annals of plastic surgery</jtitle><addtitle>Ann Plast Surg</addtitle><date>2004-08-01</date><risdate>2004</risdate><volume>53</volume><issue>2</issue><spage>111</spage><epage>117</epage><pages>111-117</pages><issn>0148-7043</issn><eissn>1536-3708</eissn><coden>APCSD4</coden><abstract>Severe gunshot wounds to the face, produced by high-velocity rifles or shotgun blasts, present a formidable challenge to reconstructive surgeons. In this study, the results of 14 cases with gunshot wounded faces caused by fire from rifles are presented, and the principles of the management of those victims were determined. These patients had attempted to commit suicide and placed the muzzles of the rifles beneath their chins. The ages of the patients ranged from 20 to 24 years, with a mean age of 22 years. These wounds were caused by close-range gunshots (<10 cm), and the missiles had high velocity (more than 800 m/second). All patients had wounds in their submental triangle areas. The exit sites of the missiles differed among patients. All exit wounds were in the angle limited by the deviation from the gun-barrel axis. After clinical and radiologic evaluation and conservative debridement of all devitalized tissues, the fractures were reduced and stabilized appropriately. Large bony defects were treated by bone grafting, and all soft tissue lesions were closed in layers. The entrance and exit sites were covered primarily after thorough debridement except one case whose defect was reconstructed with bilateral sternocleidomastoid (SCM) flaps, one for submental skin and the other for the mouth floor. Intraoral soft tissues were then repaired by primary closure, tongue flaps, or SCM flaps in case they were necessary. Free tissue transfers were not required for treatment of secondary soft-tissue problems. Resolution of tissue edema, softening of scars in time, and insertion of bone graft may improve the deformity significantly. The initial anatomic reconstruction of the existing bone skeleton and the maximal use of regional tissue for cutaneous reconstruction provide an esthetic appearance that can never be duplicated by secondary reconstruction.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>15269577</pmid><doi>10.1097/01.sap.0000116304.70332.26</doi><tpages>7</tpages></addata></record> |
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| ispartof | Annals of plastic surgery, 2004-08, Vol.53 (2), p.111-117 |
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| subjects | Adult Biological and medical sciences Debridement Facial Injuries - surgery Humans Mandibular Injuries - surgery Maxilla - injuries Medical sciences Reconstructive Surgical Procedures Soft Tissue Injuries - surgery Suicide, Attempted Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Wounds, Gunshot - surgery |
| title | Management of maxillofacial problems in self-inflicted rifle wounds |
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