Massive facial trauma following improvised explosive device blasts in Operation Iraqi Freedom

To investigate the association of massive facial trauma with brain and eye injuries, injury severity scores, and blood transfusion utilization.

Retrospective study.

Air Force Theater Hospital, Balad, Iraq.

Retrospective review of US service members injured by improvised explosive devices and treated at the Air Force Theater Hospital in Iraq from October 2004 to September 2007. Massive facial trauma was defined as any injury to the face involving 3 or more facial aesthetic units. The anatomic injury patterns, injury severity scores, and blood transfusion rates of simple and massive facial trauma were compared.

One hundred four patients who sustained facial trauma from improvised explosive device blasts were reviewed, including 29 patients with massive facial trauma. The average injury severity score was 13.9 in the simple facial trauma group and 21.7 in the massive facial trauma group (P = .006). Sixteen (55%) of the patients in the massive facial trauma group received transfusions compared with only 21 (28%) in the simple facial trauma group (P = .009). The rate of associated eye injury was 55% in the massive facial trauma group and 27% in the simple facial trauma group (P = .006). Brain injuries occurred in 48% of the patients with massive facial trauma and 28% of the patients with simple facial trauma (P = .05).

There is an association between massive facial trauma higher injury severity scores, higher transfusion rates, and an increased risk for eye and brain injuries.