Management of High-Energy Avulsive Ballistic Facial Injury: A Review of the Literature and Algorithmic Approach

    March 2018 in “ Plastic and Reconstructive Surgery – Global Open ”
    Elbert E. Vaca, J Bellamy, Sammy Sinno, Eduardo D. Rodriguez
    Image of study
    TLDR Early surgical treatment for severe facial injuries from high-energy impacts leads to better recovery.
    The document summarized the management of high-energy avulsive ballistic facial injuries, highlighting the benefits of early and aggressive surgical intervention. It included a systematic review of 17 articles, with one providing level 3 evidence suggesting that early management leads to better outcomes, such as fewer soft-tissue contractures, fewer total procedures, and shorter hospital stays. The review also noted a geographical difference in management preferences, with delayed reconstruction favored in the Middle East and immediate or early reconstruction favored in the United States. The document emphasized the lack of studies comparing debridement timing or flap selection based on defect characteristics. Despite the limited evidence, an algorithm for a 3-stage reconstructive approach was proposed, advocating for early and definitive reconstruction using aesthetic free tissue transfer. The document also discussed the importance of CT scans and CSP for planning, the use of free tissue transfer and bone grafting, and the need for secondary revisions, including hair micrografting. Case reports demonstrated the advantages of early definitive reconstruction in maintaining facial proportions. The conclusion called for more comparative studies to confirm the proposed benefits of early intervention.
    Discuss this study in the Community →

    Research cited in this study

    3 / 3 results

    Related Community Posts Join

    6 / 1000+ results

      community Is this regrowth? My doctor took these photos and said I looked better.

      in Satire  142 upvotes 2 months ago
      The conversation humorously discusses an extensive and exaggerated hair loss treatment regimen, including finasteride, dutasteride, minoxidil, pyrilutamide, RU58841, and various other therapies. Despite the numerous treatments, the effectiveness is questioned, and the user humorously considers adding more minoxidil.

      community Hair Loss Inflammation Prevention Stack

      in Research/Science  42 upvotes 6 days ago
      The conversation discusses a hair loss and scalp care routine involving ciclopirox shampoo, benzoyl peroxide, clindamycin gel, clobetasol propionate, and calcipotriol to manage seborrheic dermatitis, folliculitis, and inflammation. It also touches on the role of diet and other treatments like oral minoxidil and pioglitazone for scalp health.

      community Hair regrowth after 2 years of finasteride

      in Progress Pictures  966 upvotes 6 days ago
      A user shared their positive experience with hair regrowth after two years of using finasteride, reporting no side effects. Other users discussed their experiences, including side effects like gynecomastia, and shared advice on managing potential risks.

      community Hair Growth Progress Reversed. Help.

      in Treatments  128 upvotes 1 week ago
      The user experienced hair regrowth with oral Minoxidil, dandruff shampoo, topical Nanoxidil, and Revita Shampoo but lost progress after stopping Nanoxidil temporarily. They are now using topical Nanoxidil and oral dutasteride but are experiencing increased shedding and are unsure whether to continue or revert to their original regimen.

    Related Research

    1 / 1 results