PEACETIME GUNSHOT MAXILLOFACIAL INJURIES

Abstract

For the past years, peacetime gunshot injuries became topical for maxillofacial surgeons. Seven patients (all were males) with isolated gunshot injuries were under observation of the authors. According to the types of guns, two cases were with pistol, five with hunting guns (16 caliber), respectively. According to the injury structure, four cases belonged to suicide attempts (three – hunting guns, one pistol)and three to negligent handling of firearms (two hunting guns, one pistol).  Patient hospitalization time was 2-16 hours after the accident occurred (four patients were transferred from the region). Degree and character of gunshot injuries depended on the type of weapon and gunshot distances. The wounds were contact –penetrating, directed from under the chin area and traveled upward.  All injuries belonged to the category of heavy traumas, but wounds due to suicide attempts using 16-caliber hunting gun, were considered as especially heavy (three cases) - extensive injury of soft and hard tissues with tissue defects, chin, nose, upper jaws were torn off.  Basic principle of surgical treatment of gunshot wounds was - one moment primary surgical treatment of wounds with fixation of bone fragments and application of plastic surgery methods to regenerate tissue defects.  According to the authors’ data, regarding wide scope of maxillofacial gunshot injuries, specific approach to the diagnostics and treatment is needed. Late and incomplete primary surgical treatment leads to the development of sustainable and difficult to repair scar deformities, for elimination of which complex, multi-step surgical interventions are needed, results of which are not always satisfactory.