Abstract
INTRODUCTION: Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. METHODS: A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. RESULTS: Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 378-381 |
| Number of pages | 4 |
| Journal | Annals of Plastic Surgery |
| Volume | 68 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 1 2012 |
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Keywords
- county hospital
- epidemiology of gunshot injuries to head and neck
- gunshot injuries to face
- gunshot injuries to head and neck
- patterns of facial injury
- treatment of facial gunshot injuries
ASJC Scopus subject areas
- Surgery
Cite this
Gunshot wounds to the face : Level I urban trauma center: A 10-year level I urban trauma center experience. / Pereira, Clifford; Boyd, J. Brian; Dickenson, Brian; Putnam, Brant.
In: Annals of Plastic Surgery, Vol. 68, No. 4, 01.04.2012, p. 378-381.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gunshot wounds to the face
T2 - Level I urban trauma center: A 10-year level I urban trauma center experience
AU - Pereira, Clifford
AU - Boyd, J. Brian
AU - Dickenson, Brian
AU - Putnam, Brant
PY - 2012/4/1
Y1 - 2012/4/1
N2 - INTRODUCTION: Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. METHODS: A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. RESULTS: Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.
AB - INTRODUCTION: Gunshot wounds (GSWs) to the face are an infrequent occurrence outside of a war zone. However, when they occur, they constitute a significant reconstructive challenge. We present our 10-year experience at an urban level I trauma center to define the patterns of injury, assess the morbidity and mortality, and estimate the cost to the health care system. METHODS: A retrospective review was performed on all patients admitted to Harbor-UCLA Medical Center with GSWs to the head and neck region between January 1997 and January 2007. Those who had sustained GSWs to the face requiring operative intervention were closely reviewed. RESULTS: Between 1997 and 2007, a total of 702 patients were admitted to the Harbor UCLA Emergency Department having sustained GSWs to the head and neck region, of which 501 patients survived. Of the survivors, 28 patients (26 male, 2 female) sustained GSWs to their face requiring operative intervention. The mean age of these patients was 28 (±8.3) years. They generally presented within a few hours of the injury, but 1 individual arrived over 24 hours later. Low-velocity single gunshots (from handguns) were predominantly involved, with facial fractures occurring in all cases. Fractures were of a localized shattering type without the major displacement of bony complexes seen in motor vehicle accidents. Most required wound debridement and fracture fixation. A few patients (14.2%) underwent free tissue transfer for reconstruction (3 fibular flaps, 1 TRAM). Tracheostomy was performed in 35.7% of patients. Mean length of hospital stay was 8.3 (±7.1) days, with 50% of cases requiring admission to the intensive care unit. Mean length of intensive care unit stay was 5.2 (±5.7) days. The average cost per patient exceeded $100,000.
KW - county hospital
KW - epidemiology of gunshot injuries to head and neck
KW - gunshot injuries to face
KW - gunshot injuries to head and neck
KW - patterns of facial injury
KW - treatment of facial gunshot injuries
UR - http://www.scopus.com/inward/record.url?scp=84858846400&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84858846400&partnerID=8YFLogxK
U2 - 10.1097/SAP.0b013e31824eefc8
DO - 10.1097/SAP.0b013e31824eefc8
M3 - Article
C2 - 22421483
AN - SCOPUS:84858846400
VL - 68
SP - 378
EP - 381
JO - Annals of Plastic Surgery
JF - Annals of Plastic Surgery
SN - 0148-7043
IS - 4
ER -