Jenzer Andrew C, Storrs Bradley P, Daniels Zachary, Hanlon Jeremy J
Department of Oral and Maxillofacial Surgery, Womack Army Medical Center, Fort Bragg, NC, USA.
Craniomaxillofac Trauma Reconstr. 2020 Jun;13(2):133-137. doi: 10.1177/1943387520902893. Epub 2020 Mar 16.
Gunpowder inclusion injuries are rare occurrences in the civilian sector but are more frequently encountered in the military setting. The authors report a case series of 3 active duty military service members treated by an Army hospital's Oral & Maxillofacial Surgery service for the removal of embedded gunpowder particles so as to avoid traumatic tattooing.
Three otherwise healthy active duty military service members were treated for gunpowder inclusion injuries incurred while conducting live fire training exercises at a state-side military installation between 2018 and 2019. All 3 males presented with injuries of the same etiology: Their weapons malfunctioned, and while visually inspecting the action, a round exploded close to the face. This peppered the face with gunpowder particles that were both superficially and deeply embedded. Treatment focused on individual removal using fine forceps. The patients were followed up and healed quickly without any complications, specifically without traumatic tattooing from the gunpowder injuries.
Gunpowder inclusion injuries should be addressed quickly to remove the particles before epidermal healing occurs, thus avoiding the complication of traumatic tattooing. This surgical team recommends meticulous fine forceps removal as the treatment of choice for larger particles.
火药嵌入伤在民用领域较为罕见，但在军事环境中更为常见。作者报告了一系列病例，3名现役军人因嵌入的火药颗粒接受了陆军医院口腔颌面外科的治疗，以避免创伤性纹身。
2018年至2019年期间，3名原本健康的现役军人在美国本土军事基地进行实弹训练时因火药嵌入伤接受治疗。所有3名男性的受伤原因相同：他们的武器发生故障，在对枪支进行目视检查时，一发子弹在面部附近爆炸。这使得火药颗粒溅射到面部，既有浅表嵌入的，也有深部嵌入的。治疗重点是使用精细镊子逐个取出颗粒。对患者进行了随访，他们恢复迅速，没有出现任何并发症，特别是没有因火药伤导致创伤性纹身。
应在表皮愈合前迅速处理火药嵌入伤，以清除颗粒，从而避免创伤性纹身的并发症。该手术团队建议，对于较大颗粒，精心使用精细镊子取出是首选治疗方法。
