Multistage Management of Complex Maxillofacial Defects Due to Gunshot Injury

Abstract

Background and Aim: The injuries due to gunshot can form extensive defects. The management of these defects is required in multistage procedures, and the treatment achievement should be evaluated in many aspects. In this study, a methodology was tried to be developed to reveal the path to be followed in the management of maxillofacial defects caused by high-energy close-range gunshot injury. In addition, similar cases were analyzed retrospectively, and the functional and social successes of the treatment were evaluated. Subjects and Methods: Five patients with high-energy gunshot injuries were retrospectively analyzed. The tissue requirements of the patients were identified. The technical and quantitative details of the treatment were recorded. The facial disability index was used to evaluate the patient's social and motor functions in the 1st year after the operations were completed. Results: The patients' mean age was 31 (17–45), and all of them were male. The mean follow-up time was 25 months (14–26), and the mean operation amount was 7.6 (3–11). Four mandibular, one maxillary, and five soft-tissue defects were detected. It was detected that these defects were managed in basic four steps. Satisfactory, functional, and social results were obtained in four patients in the postoperative 1 year. Conclusions: The management of this group of patients comprises complicated procedures. First, the patient should be stabilized vitally. Definitive reconstruction should be carried out after the wound is stabilized. To increase treatment success, the patient's mental status should be stabilized during the treatment period. Providing social function is important along with physical function.