Soft Tissue Injuries:
- Laceration(most common form of facial injury)
- Contusion (with or without hematoma)
- Abrasion
- Avulsion
- Puncture
- Accidental Tattoo
- Retained Foreign Bodies
Treatment of Soft Tissue Injuries
- Primary closure
- Delayed primary closure
- Secondary healing
- Tertiary healing (skin grafts, flaps)
Emergency Treatment
- Clear Airway and provide patent airway
- Cleaning of blood, vomit and theet from inside of mouth with fingers
- Aspiration of blood, saliva, and gastric contents
- Early Intubation or Tracheostomy
- Control Hemorrhage
- Direct pressure on the wound
- Tying of bleeding vessels(a. Facialis, a. Temporalis superfic., a. Angularis, a. Carotis externa)
- Angiographic demonstration and embolization of the bleeding point
- Anterior-posterior nasal packing
- Treat Shock
- Evaluate Associated Injuries ( cervical vertebrea, skull base, intracranial, thoracal, intraabdominal)
- Diagnosis and treatment of facial injuries
Indications of Tracheostomy
- Panfacial fracures(combined mandible, maxilla and nasal fractures)
- The multiply fractured mandible with significant swelling of the neck and floor of the mouth
- Patients who require prolonged intermaxillary fixation who have significant head or chest injuries
- Possibility of prolonged postop. airway problems
- Severe facial and neck edema resulting from soft tissue injuries such as severe facial burns
- Unrelieved obstruction of airway in the region of larynx or the hypopharynx
- Lower Level fractures (Le-Fort I, Transverse, Guerin)
- transverse fracture separating the maxillary alveolus from the upper mid face
- Upper Level Fractures
- Le-Fort II(Pyramidal fracture) : separates a pyramid-shaped central fragment containing the maxillary dentition from the remainder of the orbits and upper craniofacial skeleton
- Le-Fort III (craniofacial dysjunction) : separates the maxilla at the level of the upper portion of the zygoma, orbital floor, and nasoethmoid region from the remainder of the upper craniofacial skeleton