Management of the mangled face by a forward surgical team

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Facial Reconstruction

Background:

• Mangled face injuries are rare but severe combat zone injuries.
• Initial management prioritizes the ABCs: Airway, Breathing, and Circulation.
• Dramatic disfigurement can obscure life-threatening conditions.

Observation:

• An Afghan civilian presented with a severe mangled face injury.
• Standard trauma assessment focused on airway patency, respiratory effort, and hemorrhage control.
• The patient sustained blunt, penetrating, and explosive trauma.

Findings:

• Effective airway management was achieved despite facial devastation.
• Hemorrhage control involved innovative application of a circumferential compression sling and laparotomy sponge packing.
• These techniques, typically used elsewhere, proved crucial for managing facial bleeding.

Implications:

• This case demonstrates the adaptability of hemorrhage control methods in extreme facial trauma.
• It underscores the importance of fundamental trauma care principles regardless of injury severity.
• The findings may inform future protocols for managing mangled face injuries in austere environments.