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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY

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Official Journal of the Italian Society of Maxillofacial Surgery


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Rivista Italiana di Chirurgia Maxillo-Facciale 2001 August;12(2):107-11

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: English

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


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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.

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