Firat Cemal, Geyik Yilmaz
Department of Plastic Surgery, Inonu University School of Medicine, Malatya, Turkey.
J Craniofac Surg. 2013 Jul;24(4):1322-6. doi: 10.1097/SCS.0b013e31829978c3.
Maxillofacial traumas caused by gunshot wounds may cause quite varied defects. The objective of this study was to evaluate the reconstruction methods in 12 patients with gunshot wound-related mandibular and maxillofacial bony and soft tissue defects. Twelve patients who were operated on for maxillofacial gunshot wounds at our clinic between 2002 and 2012 were included in the study. Seven patients were wounded in a suicide attempt, and 5 were wounded as a result of an accident or in assaults. Two patients underwent reconstruction using free fibula osteocutaneous flap, 4 patients received the free radial forearm osteocutaneous flap, 2 patients received costal bone graft, and 3 patients received iliac bone grafts. Satisfactory functional and aesthetic outcomes were achieved in cases where staged secondary reconstruction, balloon treatment, and consecutive fat and steroid injections into the depressed scar areas were applied. In conclusion, the basic goal in maxillofacial reconstruction is the functional and aesthetic reconstruction of the contours. Because it is not easy to get perfect results with only 1 clinical approach or 1 method, the proper timing and reconstruction method should be selected.
枪伤导致的颌面创伤可能会造成多种多样的缺损。本研究的目的是评估12例因枪伤导致下颌及颌面骨与软组织缺损患者的重建方法。本研究纳入了2002年至2012年间在我院接受颌面枪伤手术的12例患者。7例患者为自杀未遂致伤，5例因意外或袭击受伤。2例患者采用游离腓骨骨皮瓣进行重建，4例患者接受游离桡骨前臂骨皮瓣，2例患者接受肋骨移植，3例患者接受髂骨移植。在采用分期二次重建、球囊治疗以及对凹陷性瘢痕区域连续进行脂肪和类固醇注射的病例中，取得了满意的功能和美学效果。总之，颌面重建的基本目标是轮廓的功能和美学重建。由于仅采用1种临床方法或1种手段不易获得完美结果，因此应选择合适的时机和重建方法。
