Self-inflicted shotgun wounds of the face: surgical and psychiatric considerations.

This study reviews the evaluation and treatment of patients with extensive self-inflicted shotgun wounds to the face. Five cases are presented and assessed with regard to reason for suicide, psychological reaction to facial reconstruction, and the potential for social rehabilitation. Mechanisms of injury, acute management, and definitive surgical and psychiatric treatment programs are discussed. Survival is expected for most patients, and carefully planned surgical reconstruction must be coordinated with skilled psychiatric intervention.