Management of high velocity and high-energy blast Injuries to the maxillofacial region at Nasserr Institute

Management of gunshot injuries to the face remains a cornerstone of the specialty of oral and maxillofacial surgery. Since the events of January 2011, the number of firearm related injuries has increased in Egypt, which was not the case since October 1973; this represented a challenge to both residents and experienced surgeons, owing to the complex nature of these injuries. The major types of gunshot injuries are blasts, either low order or high order explosives, high velocity and low velocity injuries. The severity of the injury depends on velocity, type of bullet and distance, resulting wounds could be penetrating, perforating or avulsive. The timing, sequence and prioritization of treatment remains the main areas of concern in the management of such complex cases. The following is the experience of the Maxillofacial Department at Nasser Institute in management of high velocity and high-energy blast Injuries to the maxillofacial region.18 cases of Maxillofacial gunshot injuries were admitted to Nasserr institute between January 2011 and October 2012 which was a time of street disturbances in Egypt, only nine patients met the criteria of selection suffering from high velocity injuries were included. Upon arrival, all patients underwent a primary survey and extensive clinical and radiographic examination, accordingly a treatment plan was set for each patient and surgical intervention there after according to the protocol we present. Based on our results and treatment outcome for all patients, we conclude that triaging gunshot injuries to a prepared trauma center, following a well-tailored protocol and the use of computer aided surgical simulation is an integral part to perfect the functional and esthetic outcome and treatment.