Høgevold H E, Lyberg T
Avdeling for maxillofacial kirurgi, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1997 Jan 20;117(2):240-5.
Patients with gunshot injuries in the maxillofacial region should be resuscitated and subjected to a general examination in the emergency room. Chest X-rays and head CT scans should be performed on a routine basis, and in selected cases angiography and plain X-ray films of the cervical columns are also recommended. Treatment of the facial defects depends to some degree on the type of firearm involved, i.e. high velocity rifle, low velocity weapon or shotgun. The traditional treatment for war and civilian gunshot injuries to the face has been debridement, soft tissue closure and conservative treatment of fractures, with closed reduction and external fixation. This treatment may leave inadequate stabilization of remaining bone fragments, with collapse and later contraction of soft tissue. It fails to take advantage of the modern craniofacial and microsurgical techniques used in a more recent approach that can be termed initial final treatment of gunshot wounds. This treatment modality is recommended for civilian low velocity gunshot injuries and, after repeated debridements, also for injuries caused by shotguns and high velocity weapons.
颌面区域枪伤患者应在急诊室进行复苏和全面检查。应常规进行胸部X光和头部CT扫描，在某些特定情况下，还建议进行血管造影和颈椎平片检查。面部缺损的治疗在一定程度上取决于所涉及的火器类型，即高速步枪、低速武器或霰弹枪。传统上，战争和民用面部枪伤的治疗方法是清创、软组织缝合以及骨折的保守治疗，采用闭合复位和外固定。这种治疗可能会使剩余骨碎片的固定不足，导致软组织塌陷和后期收缩。它没有利用现代颅面和显微外科技术，而在一种可称为枪伤初始最终治疗的最新方法中会用到这些技术。这种治疗方式适用于民用低速枪伤，在反复清创后，也适用于霰弹枪和高速武器造成的损伤。
