Management of facial gunshot wounds

To determine pattern and presentation in terms of site of injury, airway, associated injuries; and management of facial gunshot wounds.

Case series.

Oral Surgery Department, Armed Forces Institute of Dentistry, Rawalpindi, between January 2001 and December 2008.

All patients with gunshot wounds of the face managed at the Oral Surgery Department during the study period were included by convenient sampling method. Patients were treated by a multidisciplinary team of maxillofacial surgeon, otorhinolaryngologist and plastic surgeon. Descriptive statistics were used to determine frequencies and mean + or - SD for qualitative and quantitative variables respectively.

A total of 38 patients with gunshot wounds to the face were identified. Age ranged from 15 to 42 years with mean of 28 + or - 4.98 years. There were 32 (84%) males and 06 (16%) females. Twenty two (57%) patients required airway management. The most frequent site involved was mandible in 25 (65%) patients while midface was involved in 13 (35%) patients. Open reduction and internal fixation (ORIF) was performed in 17 (44%) patients, while 21 (56%) patients were managed conservatively. Out of 38 patients, 15 (39%) patients had some complications; trismus, sinusitis and infection being the most frequent (10.5% each).

Facial gunshot wounds frequently involve mandible with more likely requirement of establishment of emergency airway and open reduction and internal fixation (ORIF). Early management of gunshot wounds results in better psychosocial profile, aesthetics, reduced hospital stay and early return to function.