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At least 127 records · Page 7Linked to original sources

Management of severe facial injuries by local tissue traction.

PURPOSE: To evaluate the technique of tissue traction for the management of severe facial injuries. PATIENTS AND METHODS: Twenty patients, 15 adults and five children, with severe soft tissue facial disfigurement resulting from war injuries were treated by the tissue traction technique. RESULTS: This procedure provides a cosmetically acceptable appearance when used as an immediate measure. A few complications were encountered in delayed cases such as areas of skin breakdown and some stiffness. CONCLUSION: The described technique proved to have several advantages over other more commonly used methods for closure of large wounds.

Adult↗

A comparison of facial protection and the incidence of head, neck, and facial injuries in Junior A hockey players. A function of individual playing time.

A cohort of 282 elite amateur ice hockey players were analyzed to 1) record the number, type, location, and severity of head, neck, and facial injuries sustained during games; 2) examine the relationship between injuries and the type of facial protection (none, partial, or full) according to individual playing time; and 3) determine whether full or partial facial protection is associated with an increased incidence of concussions, eye injuries, and neck injuries. Fifty-two injuries (158.9 per 1000 player-game hours) occurred in players wearing no facial protection, 45 (73.5 per 1000 player-game hours) in players wearing partial facial protection (half shield), and 16 (23.2 per 1000 player-game hours) in players wearing full facial protection (full cage or shield). Players wearing no protection were injured at a rate more than twice that of players wearing partial protection and almost seven times higher than those wearing full protection. Concussions occurred in four players wearing no protection, five players wearing partial protection, and two players wearing full protection; these differences were not significant. The risk of eye injury was 4.7 times greater for players wearing no protection compared with those wearing partial protection. No eye or neck injuries occurred in players wearing full protection. This study demonstrates that both full and partial facial protection significantly reduce injuries to the eye and face without increasing neck injuries and concussions.

Athletic Injuries↗

[Brighton epistaxis balloon: application for cranio-facial injury].

Head injury patients often complicate facial and/or multiple injuries other than cranio-cerebral insults and perplex the emergency staffs. The authors used Brighton epistaxis balloon for such patients with massive nasal bleeding and reported the utility of the balloon not only in such state of emergency but also for a few days to control the hemorrhage mostly caused by craniobasal fractures or rupture of the adjacent vessels. One hundred and twenty-nine patients were transported and hospitalized in Department of Emergency Medicine, University of Tokyo Hospital, Tokyo, Japan during the period from October, 1981 to January, 1983. Nasal bleeding was noted in 29 cases of them and the balloon was used in 10 cases, who were from 19 to 76 years of age, all males and suffered from basal fractures or craniofacial injuries. Six cases of them were also accompanied with fractures in the extremities or pelvis, hemopneumothorax and/or intra-abdominal bleeding and could not but put on "Military anti-shock trousers" for the management of hypovolemic shock, hence the nasal bleeding should be managed immediately in the emergency room. In these situations the balloon was inserted into both nasal cavities in all the patients, to control successfully the nasal hemorrhages one of which contaminated cerebrospinal fluid and three of which were sure to be pulsatile due to arterial injury. The Brighton epistaxis balloon is to be removed within twelve or twenty-four hours, but in the authors' cases the mean duration for the hemostasis was 58.9 hours for 6 survivors and 49.6 hours for all 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Facial injuries caused by animals in northern Nigeria.

We did a retrospective survey of 34 patients who sustained facial injuries after animal associated incidents and presented to three Nigerian teaching hospitals. There were 27 male (79%) and 7 female patients, whose ages ranged from 6 to 40 years. Sixteen (47%) were less than 15 years. Cows (n=14), camels (n=9), and donkeys (n=6) were the most commonly involved. Three dog bites were seen. Knocks from cows' horns (n=9) were the predominant mechanism of injury, followed by falls (n=8) and kicks (n=7). There were many facial lacerations and fractures, and the cheek (n=14), forehead (n=13), and chin (n=10) were the most common sites of soft tissue injury. All injuries were considered to be contaminated irrespective of the duration of the injury. Treatment consisted of thorough debridement and irrigation, primary closure where feasible, and secondary reconstruction in others. All patients were given prophylactic broad-spectrum antibiotics. Overall, outcome was satisfactory except for a few cases of scar formation, facial nerve palsy, and partial laryngeal stenosis. Associated injuries were recorded in nine cases (27%), with rupture of the globe in three patients (9%). One patient died of associated abdominal injuries after being trampled by a herd of cattle. There is a need for adequate protective measures to forstall animal-related incidents that could result in severe facial and other injuries.

Adolescent↗

Ocular and facial injuries associated with the use of immersion heaters in an inmate population.

PURPOSE: To report ocular and facial injuries caused by the use of electric immersion heaters in an inmate population. DESIGN: Prospective observational case series. METHODS: Data were recorded over a six-month period on age, gender, mechanism of injury, examination, and treatment of Dallas County inmates who experienced ophthalmic injuries from immersion heaters and were referred to a tertiary-care center. RESULTS: Eight male inmates were treated for thermal ocular injuries, which occurred within jail cells as a result of cooking explosions from electric immersion heaters, known by inmates as "stingers." All patients had thermal eyelid burns, either first- or second-degree facial burns, and corneal abrasions with corneal edema. Corneal metallic foreign bodies were removed in one patient, and three patients underwent debridement for corneal sloughing. CONCLUSIONS: Immersion heater-related accidents may cause thermal injuries within the inmate population. Physicians evaluating incarcerated patients with ocular trauma should be aware of immersion heaters as a common cause.

Adolescent↗

Intracranial aerocele in facial injury.

Aspects of intracranial aerocele are described and exemplified by two cases which presented to the Plastic Surgery Unit. Austin Hospital, Melbourne, as radiological findings incidental to facial injury. The first case illustrated the occasional problem of identifying the site of dural tear; a fracture could not be identified on X-ray film or at operation, and this can make subsequent dural repair more difficult. The second case was associated with florid clinical signs of facial fractures which were supported by X-ray findings. Both patients underwent surgery for the primary injury, and received prophylactic therapy with antibiotic agents because of the risk of meningitis associated with dural tears. In neither case did intracranial air persist beyond 14 days; therefore, dural repair was not performed. It is important to look for evidence of dural damage when dealing with facial injury either in the casualty or in the subsequent management of the patient.

Adult↗

Severe facial injuries to infants due to unprovoked attacks by pet ferrets.

Three infants were attacked by pet ferrets and sustained severe facial injuries. Two of the children had their ears bitten off and required reconstructive surgery. The attacks were unprovoked. Two of the children were asleep in their cribs when they were bitten. Although ferrets are increasingly popular pets, we believe that they are not suitable pets for families with small children. Physicians should be aware that ferrets may unpredictably injure infants and that no effective rabies vaccine for ferrets is yet available.

Animals↗

[Mountain sports: their role in 2200 facial injuries occurring over 4 years at the University Hospital Center in Grenoble].

Injuries caused by mountain sports account for many of the injuries admitted to the University Hospital of Grenoble. Out of 4,490 traumas, 470 were injuries sustained during the practice of mountain sports. While the frequency of these accidents does not evolve much, the etiological distribution depends on fashion. Thus an increasing number of lesions caused by cross-country biking has been noted during the past two years. We find it urgent to propose protective measures adapted to this new sport.

Accidents↗

[Facial injury by fishing harpoons].

The methods of removing penetrating fish-hooks or harpoons are unique and require understanding of the structures of these instruments and their mechanisms, and methods of neutralization. We describe 2 cases of penetrating spear-gun fishing harpoon to the face and the recommended clinical management.

Adult↗

A biomechanical impact test system for head and facial injury assessment and model development.

A biomechanical test system has been developed and validated to conduct controlled uniaxial impact experiments of head and facial trauma. The design reduces off-axis accelerations which are not in the direction of impact and allows accurate positioning of test specimens. Impact forces, displacement histories, impulses at impact and spectral responses are compared to free-fall test results at contact velocities representative of facial injuries (2.5, 3.1 and 3.8 m s-1). Models based on the experimental results are developed to reveal stiffness and inertial properties of impact for use in the design of biomechanically protective steering wheels, air bags and other potential impact structures. The results indicate that the system provides a flexible yet controllable method for positioning and testing impact structures reliably.

Accidents, Traffic↗