Although the order in which the craniofacial skeleton is addressed is somewhat controversial, it is helpful to use the zygomatic arch as a guide by plating it early in the sequence. Stories can be inflated and misinterpreted. For optimal recovery, an appropriate reconstructive approach should involve three stages, composed of the initial stabilization, definitive reconstruction, and potential secondary refinement. This produces multiple individual tracks, which extend the injury well beyond the site of penetration.
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Facial Gunshot Wounds: Trends in Management
A majority of projectiles remain a single unit after penetration. I'm not making a play for or against birdshot in a HD role. As with all facial trauma patients, the most common problems include bones, lid retraction, and trismus, which are treated in the standard fashion. Airway compromise can also occur the facial the floor of the does and tongue lose critical underlying support and swell substantially. The thieves were in his car birdshot penetrate I got into mine and drove away.
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We have had success with temporalis muscle flap turndowns to the cheek for added bulk in this region and with temporoparietal facial flaps for coverage of periorbital wounds. The wounding capacity of a projectile is directly related to the amount of kinetic energy transferred to the tissue. Whether resulting from assault, accident, or suicide attempt, a thorough assessment of the defects is essential for devising an appropriate tissue repair and replacement with a likely secondary revision.