Early treatment of facial trauma.

Early local care of maxillofacial trauma involves identification and diagnosis of the injuries and early consultation with the appropriate specialists (ie, plastic surgeon, ophthalmologist, otolaryngologist, oral and maxillofacial surgeon). Treatment of the injuries should proceed from the inside mucosal surface toward the cutaneous surface of the face, after occlusal patterns have been established and preliminary fixation of maxillary and mandibular fractures has been effected. Closure of through-and-through lacerations from the inside out and establishment of the mandible as a stable plane against which the remainder of the face may be oriented (the "inside out and bottom up" approach) provide an excellent basis for later definitive rehabilitation.