Incidence Pattern of bear-inflicted injuries to the Maxillo-Facial region- Soft and hard tissue injuries their Management and Sequelae

Publication date: Available online 3 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Narotam kumar Ghezta, Yogesh Bhardwaj, Rangila Ram, Razi Ahsan, Saurabh Arya

Abstract

Purpose

The aim of the study was to elucidate the incidence pattern of bear-inflected facial injuries, and to document the soft and hard tissue injuries, their management and complications.

Patients and methods

A prospective study was done on 21 bear associated injuries sustained to the facial region. Most of the patients were young to middle age, and most were males. Most of the attacks occurred during the daytime, with the highest incidence occurring during the months of April to October. The wounds were assessed for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region for over 18 months. A standardized surgical treatment was used for the management of the victim which included thorough debridement of wounds to routine primary repair of soft tissue. Bony defect reconstruction was done by open reduction and internal fixation. Regional or distant flaps were used for the reconstruction of soft tissue defects.

Results

Mauled patients were treated for injuries varying from laceration and punctured wounds to fractures and avulsive tissues. On an average, most of the victims underwent a single operation for reconstruction of bony fractures and soft tissue repair and spent 3-7 days in the hospital; however, a few patients underwent more than one operation and had to stay back for over 4-6 weeks. Facial fractures were mainly seen in the midfacial region (71%), followed by the mandibular fractures (24%). Overall, the results were satisfactory, except for a few instances of scar formation, palsy of the facial nerve, and ectropion. The mortality rate was in 5% (01) patient, the severe injury caused by bear mauling.

Conclusion

Extensive bear bite injuries on the facial skeleton may be treated with immediate primary wound repair, after meticulous wound debridement and commonly used criteria of aesthetic reconstructive facial surgery.

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