phenylephrine-hydrochloride and Eye-Injuries--Penetrating

The wearing of eye protection by United Kingdom soldiers in Afghanistan has reduced the morbidity caused by explosive fragments. However, the remaining face remains uncovered because there is a lack of evidence to substantiate the procurement of methods to protect it. Using a new computerised tool we entered details of the entry sites of surface wounds caused by explosive fragments in all UK soldiers who were injured in the face between 1 January 2010 and 31 December 2011. We compared clinical and predicted immediate and long term outcomes (as defined by the Abbreviated Injury Score (AIS) and the Functional Capacity Index (pFCI), respectively). We also used the tool to predict how additional protection in the form of a visor and mandible guard would affect outcomes. A soldier wearing eye protection was 9 times (1.03/0.12) less likely to sustain an eye injury than one without. However, 38% of soldiers in this series were not wearing eye protection at the time of injury. There was no significant difference between the AIS and pFCI scores predicted by the tool and those found clinically. There is limited evidence to support the use of a mandible guard; its greatest asset is better protection of the nose, but a visor would be expected to reduce long-term morbidity more than eye protection alone, and we recommend future trials to assess its acceptability to users. We think that use of this novel tool can help in the selection of future methods of ballistic facial protection.

Topics: Abbreviated Injury Scale; Blast Injuries; Computer-Aided Design; Equipment Design; Explosions; Eye Injuries, Penetrating; Eye Protective Devices; Facial Injuries; Forecasting; Head Protective Devices; Humans; Imaging, Three-Dimensional; Lasers; Male; Mandibular Injuries; Military Personnel; Nose; Personal Protective Equipment; Prospective Studies; Registries; Treatment Outcome; United Kingdom

A digitally captured, designed, and fabricated facial prosthesis is presented as an alternative to customary maxillofacial prosthodontics fabrication techniques, where a facial moulage and patient cooperation may be difficult.

Topics: Blast Injuries; Child, Preschool; Computer-Aided Design; Eye Enucleation; Eye Injuries, Penetrating; Eye, Artificial; Female; Humans; Nose; Optical Imaging; Photogrammetry; Prostheses and Implants; Prosthesis Coloring; Prosthesis Design

Several approaches exist for the treatment of animal attacks targeting the head and neck region. The treatment options and timing vary depending on the animal species, the nature of the defect, and the experience of the surgeon. In this study, early surgical treatment options used in head-neck injuries caused by domesticated or wild animal attacks are presented.We consider 12 patients who were admitted to our clinic between June 2006 and May 2010 with head-neck injuries caused by animal attacks. Tissue defect had developed in 10 patients due to half-wild dog bite and in 2 patients due to wolf bite. The ages of the patients ranged from 3 to 45 years (mean, 21.3 years). Among the patients included in the study, 4 had facial injury, 3 had ear, 3 had scalp, 1 had eye, and 2 had nose injuries. In all patients, early surgical reconstruction was performed after irrigation, antisepsis, and debridement. Concurrent rabies and tetanus prophylactic antibiotherapy program was started.Infection or surgical complications were not observed in any of the patients. Rabies symptoms were determined in one of the quarantined dogs under surveillance. There were no positive findings in the patient bitten by the dog. The surgical treatment results from all patients were at satisfactory levels.As a result, it is observed that, in the treatment of head and neck injuries resulting from animal bites, early acute approach has replaced the traditional long-term treatment. We believe that debridement and early surgical reconstruction used in combination with medical support and prophylactic treatment are the best treatment method.

Topics: Adolescent; Adult; Animals; Anti-Infective Agents, Local; Antibiotic Prophylaxis; Bites and Stings; Child; Child, Preschool; Craniocerebral Trauma; Debridement; Dogs; Ear, External; Eye Injuries, Penetrating; Facial Injuries; Female; Follow-Up Studies; Humans; Lacerations; Male; Middle Aged; Neck Injuries; Nose; Plastic Surgery Procedures; Povidone-Iodine; Rabies Vaccines; Scalp; Surgical Flaps; Tetanus Toxoid; Wolves

Topics: Adult; Automobiles; Brain Injuries; Craniotomy; Eye Evisceration; Eye Injuries, Penetrating; Foreign Bodies; Humans; Male; Nose; Skull Fractures; South Africa; Tomography, X-Ray Computed

Blast injuries involving the frontobasilar region and orbit can present difficult evaluation and treatment challenges. This article presents the surgical treatment of four patients presenting with blast-type injuries involving the central periorbital region and anterior skull base. Three of these were the result of close-range gunshot wounds, and one was caused by an avulsive penetrating tree branch injury during a motor vehicle accident. All four patients underwent frontal craniotomy for exposure to repair significant intracranial injuries. Following intracranial repair of dural and brain injuries, anterior cranial fossa reconstruction was performed. In two of these patients, elective supraorbital osteotomies were performed to allow improved access to the posterior aspect of the anterior skull base. The healing period of all four patients has been without complications relative to the anterior fossa injuries.

Topics: Adult; Blast Injuries; Bone Transplantation; Brain Injuries; Cerebrospinal Fluid Rhinorrhea; Craniotomy; Dura Mater; Eye Injuries, Penetrating; Female; Follow-Up Studies; Frontal Bone; Humans; Male; Nose; Orbital Fractures; Osteotomy; Skull Base; Skull Fractures; Surgical Flaps; Surgical Mesh; Wound Healing; Wounds, Gunshot; Wounds, Penetrating

Conjunctivo-dacryocystorhinostomy with a Jones glass tube serving as a conduit for tear flow is used in patients with epiphora resulting from obstructed canaliculi. The glass tube runs from the medial canthus into the nose. The author describes the use of an extended Jones tube in a patient without a nose.

Topics: Dacryocystorhinostomy; Drainage; Eye Injuries, Penetrating; Follow-Up Studies; Humans; Lacrimal Duct Obstruction; Male; Maxillary Sinus; Middle Aged; Nasolacrimal Duct; Nose; Orbit; Wounds, Gunshot