Powers David B, Delo Robert I
Duke Craniomaxillofacial Trauma Program, Division of Plastic, Reconstructive, Maxillofacial and Oral Surgery, Duke University Medical Center, DUMC Box 2955, Durham, NC 27710, USA.
Atlas Oral Maxillofac Surg Clin North Am. 2013 Mar;21(1):15-24. doi: 10.1016/j.cxom.2012.12.001.
Ballistic injury wounds are formed by variable interrelated factors, such as the nature of the tissue, the compositional makeup of the bullet, distance to the target, and the velocity, shape, and mass of the of the projectile. This complex arrangement, with the ultimate outcome dependent on each other, makes the prediction of wounding potential difficult to assess. As the facial features are the component of the body most involved in a patient's personality and interaction with society, preservation of form, cosmesis, and functional outcome should remain the primary goals in the management of ballistic injury. A logical, sequential analysis of the injury patterns to the facial complex is an absolutely necessary component for the treatment of craniomaxillofacial ballistic injuries. Fortunately, these skill sets should be well honed in all craniomaxillofacial surgeons through their exposure to generalized trauma, orthognathic, oncologic, and cosmetic surgery patients. Identification of injured tissues, understanding the functional limitations of these injuries, and preservation of both hard and soft tissues minimizing the need for tissue replacement are paramount.
弹道伤创口由多种相互关联的因素形成，如组织的性质、子弹的组成结构、与目标的距离以及射弹的速度、形状和质量。这种复杂的组合，最终结果相互依赖，使得对致伤潜力的预测难以评估。由于面部特征是身体中最能体现患者个性以及与社会互动的部分，保持外形、美容效果和功能结果应始终是弹道伤治疗的主要目标。对面部复合体损伤模式进行合乎逻辑的、循序渐进的分析，是治疗颅颌面弹道伤绝对必要的组成部分。幸运的是，所有颅颌面外科医生通过接触普通创伤、正颌、肿瘤和美容手术患者，这些技能应已得到很好的磨练。识别受损组织、了解这些损伤的功能限制以及保留软硬组织以尽量减少组织置换的需求至关重要。
