Baisden Grace C, Spence Lawson E, Perkins Jonathan N, Latham Kerry P
Department of Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland.
Saint Louis University School of Medicine, Saint Louis, Missouri.
Semin Plast Surg. 2025 Mar 26;39(1):8-13. doi: 10.1055/s-0044-1801407. eCollection 2025 Feb.
Combat ballistic injuries to the face present complex challenges for military medical personnel, often involving multiple traumas that require immediate intervention to preserve life and function. This review explores the mechanisms of ballistic trauma, highlighting the unique injury patterns seen in modern conflicts like those in Iraq, Afghanistan, Syria, and Ukraine. Advances in protective gear have altered injury profiles, increasing the incidence of head, neck, and facial injuries. Early evacuation and definitive care are critical, though prolonged field care settings may require adapted surgical techniques due to resource constraints. The goals of surgical management focus on restoring form and function, with treatment strategies influenced by the severity of injuries and available medical resources. This article also discusses the long-term complications, such as infections, nerve injuries, and posttraumatic stress disorder, emphasizing the need for a multidisciplinary approach. The evolving nature of combat injuries underscores the importance of continuous surgical innovation and timely intervention to improve outcomes for soldiers suffering from ballistic facial trauma.
面部战伤给军事医务人员带来了复杂的挑战，通常涉及多处创伤，需要立即进行干预以挽救生命和维持功能。本综述探讨了弹道创伤的机制，突出了在伊拉克、阿富汗、叙利亚和乌克兰等现代冲突中所见到的独特损伤模式。防护装备的进步改变了损伤情况，增加了头部、颈部和面部损伤的发生率。早期后送和确定性治疗至关重要，不过由于资源限制，在长期战地医疗环境中可能需要采用适应性手术技术。手术治疗的目标侧重于恢复外形和功能，治疗策略受损伤严重程度和可用医疗资源的影响。本文还讨论了长期并发症，如感染、神经损伤和创伤后应激障碍，强调了多学科方法的必要性。战伤不断变化的性质凸显了持续进行手术创新和及时干预对于改善弹道面部创伤士兵治疗效果的重要性。
