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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2001 August;12(2):107-11
Self inflicted gunshot wounds to the mandible. Pre-sentation of a clinical case
Roccia F., Francone S., Cassarino E., Brucoli M.
From the Maxillo-Facial Surgery Division S. Giovanni Battista Hospital University of Turin, Turin
Patients with gunshot wounds to the head and neck pose a wide range of medical and surgical challenges to the maxillofacial surgeon. These wounds, caused by low- or high-velocity weapons, are classified into three categories: penetrating wounds, perforating wounds and avulsive wounds. The initial evaluation and management of patients with gunshot wounds to the mandible should follow the Advanced Trauma Life Support guidelines. Resuscitation begins by establishing an airway by endotracheal intubation, tracheotomy or cricothyroidotomy. Once an adequate airway is ensured, procedures to stabilise the patient further by controlling haemorrhage can continue. A more thorough diagnostic workup can then be initiated, through CT scan and radiographic evaluation. Angiography is indicated for patients suspected of having significant vascular injury. Finally, bone and soft-tissue reconstruction may proceed.