ABSTRACT
A retrospective analysis of 828 patients with significant midface or mandibular fractures was undertaken to illustrate the multisystem nature of traumatic injuries associated with fracture of the facial skeleton, covering the period from 1985 to 1994. Special emphasis was placed on determining associated injuries sustained as well as epidemiological information. The experience presented differs from other large series in the literature in that the predominant mechanism of injury is motor vehicle accidents (67%) rather than assaults. Of the patients reviewed, 89% sustained significant associated injuries. Closed head trauma with documented loss of consciousness was noted most frequently (40%), followed by extremity fractures (33%), thoracic trauma (29%), and traumatic brain injuries (25%). Only 11% of patients sustained facial fractures without concomitant injury.
Subject(s)
Facial Bones/injuries , Multiple Trauma/epidemiology , Skull Fractures/epidemiology , Accidents, Traffic/statistics & numerical data , Adult , Arm Injuries/epidemiology , Brain Injuries/epidemiology , Female , Fractures, Bone/epidemiology , Head Injuries, Closed/epidemiology , Humans , Leg Injuries/epidemiology , Male , Mandibular Fractures/epidemiology , Maxillary Fractures/epidemiology , North Carolina/epidemiology , Retrospective Studies , Thoracic Injuries/epidemiology , Unconsciousness/epidemiology , Violence/statistics & numerical data , Wounds, Gunshot/epidemiology , Zygomatic Fractures/epidemiologyABSTRACT
Over a 3-year period, 136 patients were monitored following free autologous tissue transplantation using a laser Doppler flowmeter linked to a computerized data-acquisition system. This monitoring system has indicated perfusion compromise in free flaps more rapidly than clinical observation alone. Most important, this has resulted in an increase in salvage rate from 50.0 to 82.4 percent. In addition, our overall success rate has increased from 92.6 to 97.8 percent since introducing this monitor clinically. Computerization also has facilitated the collection of data, which has enabled us to establish expected values for postoperative blood flow in several types of donor tissues used for microvascular reconstruction. Finally, this computerized monitoring system has relieved personnel from basing decisions on subjective data.
