McLean J Nicolas, Moore Charles E, Yellin Seth A
Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, Georgia 30342, USA.
Facial Plast Surg. 2005 Aug;21(3):191-8. doi: 10.1055/s-2005-922859.
The complex facial trauma victim poses a genuine therapeutic challenge as a whole, and may be particularly challenging to the medical team. The literature on acute management of gunshot wounds to the face is scarce. We performed an extensive review of the English-language literature in an effort to better delineate the diagnosis and acute management of these injuries. Most of these injuries do not present with initial threat to life and can safely be managed non-operatively. Definitive treatment is often deferred in patients with multiple, or more severe, injuries. Airway compromise is the most frequent and most life-threatening early problem reported in most series. CT scan remains the most useful method in the evaluation of these types of injuries and associated cervical spine lesions. Facial bleeding is best controlled by angiography and subsequent embolization. Anatomic repair of soft tissue and bony injuries is recommended to obtain an optimal functional and aesthetic outcome. Despite the creation of some algorithms, no clear correlation has been found between the site of entrance wound and the injuries and outcome of gunshot wounds to the face.
复杂面部创伤患者作为一个整体对治疗构成了真正的挑战，对医疗团队而言可能尤其具有挑战性。关于面部枪伤急性处理的文献很少。我们对英文文献进行了广泛综述，以更好地描述这些损伤的诊断和急性处理。这些损伤大多最初对生命无威胁，可安全地进行非手术处理。对于有多处或更严重损伤的患者，确定性治疗往往会推迟。气道受损是大多数系列报道中最常见且最危及生命的早期问题。CT扫描仍是评估这类损伤及相关颈椎病变最有用的方法。面部出血最好通过血管造影及随后的栓塞来控制。建议对软组织和骨损伤进行解剖修复，以获得最佳的功能和美学效果。尽管制定了一些算法，但尚未发现面部枪伤的入口伤口部位与损伤及结果之间有明确的相关性。
