China Journal of Oral and Maxillofacial Surgery ›› 2019, Vol. 17 ›› Issue (1): 70-73.doi: 10.19438/j.cjoms.2019.01.014

• Clinical Reports • Previous Articles     Next Articles

Treatment of multiple cranionmaxillofacial trauma: experience in 20 consecutive cases

GE Kui1, WU Jia -jun1, QIAN Li1, WANG Fan-lin1, FAN Jing-xian1, LIANG Xiang2, SHI Jun3, ZHANG Shi-lei3, XIE Ting1, XU Bing1   

  1. 1. Department of Emergency,Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China;
    2. Department of Cardiothoracic Surgery,Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China;
    3. Department of Oral and Craniomaxillofacial Surgery,Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine. Shanghai 200011, China
  • Received:2018-07-09 Revised:2018-08-15 Online:2019-01-20 Published:2019-02-21

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Abstract: PURPOSE: To discuss the treatment strategies of severe multiple craniomaxillofacial trauma. METHODS: Twenty patients (16 males and 4 females, ranged from 9 to 83 years old, with an average age of 40.8 years old) with severe multiple cranionmaxillofacial trauma treated in Emergency Intensive Care Unit (EICU) of Shanghai Ninth People's Hospital were retrospectively analyzed from Mar. 2013 to Mar. 2018. The injury situation, treatment method and outcome, including basic life support given in first-aid room, number of injury site, damage control operation, advanced life support method in EICU, the resuscitative results and the outcome, were reviewed and analyzed. RESULTS: As basic life support, 19 patients were given debridement and hemostasis, 13 patients only received liquid resuscitation, 4 patients had blood transfusion after massive liquid resuscitation, 5 patients underwent intubation /tracheotomy, 4 patients had external fixation. For the number of injury site, 3 patients had 2 injury sites, 4 patients had 3 injury sites, 7 patients had 4 injury sites, 6 patients had 5 or more injury sites. For damage control operation, 10 patients were given damage control operation, 1 patient was given orbital exploratory operation, 1 patient underwent intracranial hematoma removal and decompressed craniectomy, 1 patient had lung repair and drainage after exploratory thoracotomy and hemostasis, 1 patient had hemostasis by percutaneous intervention, 2 patients had external fixation, 4 patients' wound were repaired by covering with native pressure after debridement. For advanced life support in EICU, 6 patients were admitted directly to operate in different departments, the others 14 patients were transferred to EICU to be given advanced life support. During the time in EICU, 10 patients were given operation by different disciplines after vital signal becoming normal, 4 patients discharged and waited for plastic surgery later because missing best chance. All patients were recovered to normal condition without death. CONCLUSIONS: Multidisciplinary co-operation and continuous life support earlier are the most important strategies for severe multiple craniomaxillofacial trauma.

Key words: Craniomaxillofacial trauma, Multiple trauma, Life support, Damage control surgery

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