+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Facial gunshot wound debridement: debridement of facial soft tissue gunshot wounds



Facial gunshot wound debridement: debridement of facial soft tissue gunshot wounds



Journal of Cranio-Maxillo-Facial Surgery 41(1): E8-16



Over the period 1981-1985 the author treated 1486 patients with facial gunshot wounds sustained in combat in Afghanistan. In the last quarter of 20th century, more powerful and destructive weapons such as M-16 rifles, AK-47 and Kalashnikov submachine guns, became available and a new approach to gunshot wound debridement is required. Modern surgeons have little experience in treatment of such wounds because of rare contact with similar pathology. This article is intended to explore modern wound debridement. The management of 502 isolated soft tissue injuries is presented. Existing principles recommend the sparing of damaged tissues. The author's experience was that tissue sparing lead to a high rate of complications (47.6%). Radical primary surgical debridement (RPSD) of wounds was then adopted with radical excision of necrotic non-viable wound margins containing infection to the point of active capillary bleeding and immediate primary wound closure. After radical debridement wound infection and breakdown decreased by a factor of 10. Plastic operations with local and remote soft tissue were made on 14, 7% of the wounded. Only 0.7% patients required discharge from the army due to facial muscle paralysis and/or facial skin impregnation with particles of gunpowder from mine explosions. Gunshot face wound; modern debridement.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 053185394

Download citation: RISBibTeXText

PMID: 22998924

DOI: 10.1016/j.jcms.2012.04.001


Related references

A prospective, randomized clinical trial of wound debridement versus conservative wound care in soft-tissue injury from civilian gunshot wounds. American Surgeon 56(2): 104-107, 1990

Debridement of civillan gunshot wounds of soft tissue. Journal of Trauma 1: 354-360, 1961

Surgical debridement of gunshot wounds. Khirurgiia 1990(6): 26-29, 1990

Débridement of gunshot wounds: semantics and surgery. World Journal of Surgery 24(9): 1146-1149, 2000

Arthroscopic debridement after intraarticular low-velocity gunshot wounds. Arthroscopy. 9(5): 576-579, 1993

The role of debridement and antibiotics in gunshot wounds to the spine. Journal of Trauma 60(4): 814, 2006

Errors in debridement of facial wounds as cause of subsequent facial deformities. Khirurgiia 35(5): 75-79, 1959

Contact gunshot wound of the head: diagnosis after surgical debridement of the wound. Journal of Clinical Forensic Medicine 6(3): 156-158, 1999

Substitute ellipse of the permanent cavity in gelatin blocks and debridement of gunshot wounds. Military Medicine 166(8): 689-694, 2001

Secondary surgical debridement in the treatment of infectious purulent complications of gunshot wounds. Khirurgiia 1994(3): 3-7, 1994

Gunshot wounds: epidemiology, wound ballistics, and soft-tissue treatment. Instructional Course Lectures 58: 131-139, 2009

Penetrating gunshot wound to the head: transotic approach to remove the bullet and masseteric-facial nerve anastomosis for early facial reanimation. Turkish Neurosurgery 24(3): 415-418, 2014

Carl Reyher (1846-1890), great Russian military surgeon: His demonstration of the role of debridement in gunshot wounds and fractures. Surgery 74(5): 641-649, 1973

Gunshot and blast injuries to the extremities. Management of soft tissue wounds by a modified technique of delayed wound closure. Acta Chirurgica Scandinavica 154(9): 495-499, 1988

Ultrasonic debridement of contaminated facial wounds. British Journal of Oral and Maxillofacial Surgery 40(2): 149-150, 2002