Experience with the treatment of facial gunshot injuries.

Treatment of facial gunshot injuries and their reconstruction is still one of the most serious problems of reconstructive surgery. Our experience comprises treatment of 23 patients with this type of injury. Five patients had primary treatment. In these patients, attention was focused on maintaining the patency of the airways, fixation of bone fragments and soft tissue reconstruction. In secondary reconstructions, principles of craniofacial surgery and microsurgery were applied. The majority of patients needed osteoplasties using classical or vascularized bone grafts. In injuries of the middle part of the face, the orbit, radix nasi and forehead, principles of craniofacial surgery were applied. The greatest problem is deformities after shotgun wound, where reconstructions cell for repeated reconstruction procedures.