Craniomaxillofacial Trauma & Reconstruction最新文献

{"title":"Factors Associated With Outcomes of Facial Reconstruction After Mohs Micrographic Surgery.","authors":"Jenny Ji, Nora Alexander, Kwasi Enin, Emily Spataro","doi":"10.1177/19433875241257981","DOIUrl":"10.1177/19433875241257981","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To determine patient, defect, and surgical factors associated with facial reconstructive outcomes.</p><p><strong>Methods: </strong>Post-Mohs Micrographic Surgery (MMS) facial reconstructions performed at a single institution between 2015-2020 were reviewed. Patient demographics, comorbidities, defect characteristics, type and timing of reconstruction, and postoperative complications and revisions were collected. Data was analyzed with multivariable logistic regressions.</p><p><strong>Results: </strong>245 defects in 220 patients (median age 66 years, 143 (65%) female) were included. Most were located on the nose (68%), and median size was 3.0 cm² (IQR 1.32-7.5 cm²). Defect size over 10 cm² (OR 5.176, 95% CI 1.353-19.808) and two-staged melolabial flaps (OR 4.021, 95% CI 1.525-10.603) were associated with complications after univariate analysis. Nasal tip defects (OR 2.324, 95% CI 1.076-5.019) were associated with minor revisions. Major revisions were associated with nasal sidewall (OR 2.873, 95% CI 1.125-7.336) and tip (OR 2.780, 95% CI 1.145-6.749) defects, ear cartilage grafts (OR 3.373, 95% CI 1.382-8.231), two-staged paramedian forehead flaps (OR 19.273, 95% CI 6.864-54.112), and delayed reconstruction over 14 days (OR 5.727, 95% CI 1.298-25.281). On multivariable analysis, defect size over 10 cm² (aOR 4.972, 95% CI 1.286-19.073) and two-staged melolabial flaps (aOR 4.575, 95% CI 1.628-12.857) were independently associated with complications, while two-staged paramedian forehead flaps (aOR 14.421, 95% CI 3.976-52.310) were independently associated with major revisions.</p><p><strong>Conclusions: </strong>More complex reconstructions with larger defects and interpolated flaps were associated with revision surgery and complications of facial reconstruction following MMS.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP131-NP137"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refining Operative Indications for Zygomaticomaxillary Complex Fracture Repair.","authors":"Rachna Goli, Vinay Rao, Joseph W Crozier, Albert S Woo","doi":"10.1177/19433875241255223","DOIUrl":"10.1177/19433875241255223","url":null,"abstract":"<p><strong>Study design: </strong>Case-control.</p><p><strong>Objective: </strong>Although zygomaticomaxillary complex (ZMC) fractures are among the most common facial injuries, the optimal approach to management remains controversial. This study analyzes the relationship between displacement measures derived from pre-operative CT imaging and clinical symptomatology to enhance surgeon understanding of the need for operative intervention.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 95 patients with ZMC fractures seen at a single institution between 2015 and 2020. Patient demographics, CT characteristics, and symptoms prompting surgery were recorded from the medical record. Statistical analysis was conducted to determine relationships between radiographic characteristics, symptomatology, and need for operative intervention.</p><p><strong>Results: </strong>Malar flattening or facial asymmetry was significantly predicted by lateral maxillary wall impaction (OR = 1.36<i>, P</i> < .001) and anterior-posterior displacement (OR = 1.18, <i>P</i> = .01). Infraorbital rim step-off was significantly associated with lateral maxillary wall impaction (OR = 1.23, <i>P</i> < .01). Vertical displacement predicted complaint of malocclusion (OR = 1.47, <i>P</i> = .03). Moreover, fractures with posterior displacement greater than 2.5 mm (OR = 14.3, <i>P</i> < .001) or lateral maxillary wall impaction greater than 4.5 mm (OR = 12.0, <i>P</i> < .001) were significantly more likely to be considered operative. Fractures displaced less than 15 mm total in all directions (OR = 16.0, <i>P</i> < .001) were less likely to require surgery.</p><p><strong>Conclusions: </strong>CT characteristics of ZMC fractures reliably predict a patient's likelihood of developing symptoms, indicating surgical intervention. We hope these findings will aid in surgical decision-making regarding the management of ZMC fractures.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP97-NP112"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orbital Trauma Epidemiologic Characteristics by Life Stage.","authors":"Aayma Irfan, Nihal Punjabi, Aishwarya Suresh, Ian Waldrop, Jared C Inman, Nicholas W Sheets","doi":"10.1177/19433875241275102","DOIUrl":"10.1177/19433875241275102","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective database review.</p><p><strong>Objective: </strong>This study aims to characterize and compare the epidemiological factors of orbital trauma between life stages by utilizing the National Electronic Injury Surveillance System (NEISS), a nationally representative database.</p><p><strong>Methods: </strong>The NEISS was queried for orbital injuries from 2013 to 2022. Demographic data, injury type, injury location, and product related to injury were compared across life stages defined as 0-5 years (young children), 6-17 years (adolescents), 18-64 years (working adults), and >65 years (elderly adults).</p><p><strong>Results: </strong>7846 orbital injuries were reported in the NEISS from 2013-2022. Incidence increased in all age groups over the study period but was highest in elderly adults. There was a bimodal distribution in the frequency of orbital trauma, with peaks occurring at age<20 and around age 80. Adolescents were most likely to be injured by sports-related products while young children and elderly adults were more likely to be injured by household products. Orbital fractures were the most common type of injury across all age groups (40.6%), with the highest rate observed in working adults. Elderly adults were more likely to be admitted to the hospital compared to working adults (RR 1.62 [1.49-1.77]).</p><p><strong>Conclusions: </strong>The rate of orbital trauma is increasing over time, especially in elderly adults, highlighting the need for increased and improved preventative and education measures. The age-specific epidemiological factors identified in this study may help improve detection and management of injuries and guide public health initiatives.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP217-NP224"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome Evaluation of Three-Dimensionally Printed Patient-Specific Surgical Plates for Mandibular Reconstruction.","authors":"Wen-Bo Zhang, Chao-Fei Wang, Yao Yu, Shuo Liu, Lei-Hao Hu, Hui Yuh Soh, Jie Zhang, Xin Peng","doi":"10.1177/19433875241272441","DOIUrl":"10.1177/19433875241272441","url":null,"abstract":"<p><strong>Study design: </strong>Prospective and retrospective studies.</p><p><strong>Objective: </strong>The aim of this study was to evaluate the clinical effects and accuracy of three-dimensionally (3D)-printed patient-specific surgical plates used for mandibular defect reconstruction.</p><p><strong>Methods: </strong>This study included patients who underwent mandibular defect reconstruction with vascularized autogenous bone grafts between January 2012 and August 2021. They were divided into experimental (fixation with 3D-printed surgical plates) and control (fixation with conventional surgical plates) groups. Flap survival rate, postoperative complications and patient self-evaluated facial appearance were compared. Mandibular reconstruction accuracy evaluation included postoperative position deviation of the whole mandible, transplanted bone graft, lower mandibular border, mandibular condyle, and mandibular angle on the reconstructed side compared to baseline.</p><p><strong>Results: </strong>This study included 20 patients (14 males, six females; age, 39.45 ± 11.69 years), ten each in the experimental and control groups. The mean follow-up was 16 ± 22.05 (range, 6-99) months. All procedures were successful, no plate-related complications (breakage, loosening, or exposure of the surgical plates) were reported, and all patients were satisfied. The groups were statistically similar in th e position deviation of the whole mandible, transplanted bone graft, mandibular condyle, and mandibular angle, but the position and morphology of the lower mandibular border on the reconstructed side in the experimental group were better than those in the control group (<i>P</i> = 0.016).</p><p><strong>Conclusions: </strong>3D-printed patient-specific surgical plates could be applied in mandibular reconstruction safely and effectively, simplifying the surgical procedure, shortening the preoperative preparation times, achieving satisfactory outcomes, and improving the clinical effects and accuracy of individualized mandibular reconstruction.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP172-NP181"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auricular Hematomas in a High-Volume Trauma Population: A Retrospective Review.","authors":"Alisa L Phillips, Jordan B Luttrell, Joseph M Berry, Raj D Dedhia, Anas Eid","doi":"10.1177/19433875241244587","DOIUrl":"10.1177/19433875241244587","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective review.</p><p><strong>Objective: </strong>Auricular hematomas are generally associated with sports-related injuries, with studies predominantly in white populations and high neighborhood socioeconomic status (NSES) compared to our county. A previous population-based study of trauma patients in our county, Shelby County, Tennessee, shows that those who live in high vs low NSES experienced socioeconomic variation in injury. We aim to determine if differences exist in clinical management and outcomes in this population.</p><p><strong>Methods: </strong>Patients from two hospital systems diagnosed with auricular hematomas from 2008-2023 were reviewed retrospectively. Inclusion criteria included adequate follow-up, clinical description of the hematoma, and comment on any complications or recurrence.</p><p><strong>Results: </strong>48 patients, with a median age of 28 (range: 0-83), with the most common etiology being assault/non-accidental trauma (NAT) at 41.7%, equally distributed across all NSES (<i>P</i> = .30), with one sports-related injury. Facial trauma consults were associated with lower recurrence rates, 25% vs 62.5% (<i>P</i> = .003) and were less likely to be placed for self-pay patients (<i>P</i> = .019). Bolster placement resulted in lower recurrence rates, 23.3% compared to 58.3% (<i>P</i> = .030).</p><p><strong>Conclusions: </strong>Higher rates of assault/NAT etiologies existed in our population, independent of NSES. Our study reiterates the importance of facial trauma consultation and bolster usage to reduce recurrence.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP36-NP43"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Premorbid Incidence of Mental Health and Substance Abuse Disorders in Facial Trauma Patients.","authors":"Adeeb Derakhshan, Hunter Archibald, Harley S Dresner, David A Shaye, Peter A Hilger, Sofia Lyford Pike, Shekhar K Gadkaree","doi":"10.1177/19433875241280780","DOIUrl":"10.1177/19433875241280780","url":null,"abstract":"<p><strong>Study design: </strong>A retrospective study.</p><p><strong>Objective: </strong>Facial trauma is a prevalent cause of morbidity and mortality with increasing incidence over recent decades. Few studies have examined the prevalence of mental health and substance abuse disorders at the time of diagnosis. Herein we investigate the psychosocial demographics associated with facial trauma.</p><p><strong>Methods: </strong>The 2016 State Inpatient Database (SID) was used to identify patients with facial trauma from all hospitals in New York, Florida, and Maryland. A non-trauma control group undergoing elective same-day surgeries at ambulatory surgical centers in Florida, Kentucky, Nevada, North Carolina, New York, and Maryland was identified using the State Ambulatory Surgery and Services Database (SASD) from the Healthcare Cost and Utilization Project (HCUP). 777 patients were identified with facial trauma and compared to 500 patients without facial fractures.</p><p><strong>Results: </strong>Patients with facial fractures were statistically significantly more likely to have a substance abuse disorder (OR 34.78, <i>P</i> < .001) or mental health disorder (OR 2.75, <i>P</i> < .001) compared to controls. Patients with facial fractures were significantly more likely to be black than white (OR 4.80, <i>P</i> < .001). Patients with facial fractures were significantly more likely to have Medicaid compared to Medicare (OR 2.12, <i>P</i> = .005).</p><p><strong>Conclusions: </strong>Patients with facial fractures are more likely to have premorbid substance abuse and mental health disorders as compared to controls.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP257-NP262"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstruction of Maxillary Bone Defects With Cellular Bone Matrix Allografts.","authors":"Jeffrey S Marschall, Stephen S Davis, Oscar Rysavy, George M Kushner","doi":"10.1177/19433875241288138","DOIUrl":"10.1177/19433875241288138","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective Cohort Study.</p><p><strong>Objective: </strong>Reconstruction of maxillary bone defects can be completed with vascularized and non-vascularized autografts. Cellular bone matrix allografts (CBMs), which have lineage committed bone cells, has risen as an alternative. The purpose of this study was to describe our experience and to determine the success of CBM based maxillary reconstruction in a variety of clinical scenarios.</p><p><strong>Methods: </strong>A retrospective cohort study was designed and implemented using data from subjects who presented to the University of Louisville and were treated with a CBM for maxillary reconstruction from 2019 to 2023. Subjects were excluded if they were not treated with a CBM, data were not complete, or postoperative follow-up time was less than 3 months. Descriptive statistics were calculated for each variable. To measure the associations between the risk factors and graft success, Fisher's exact test was implemented. A <i>P</i>-value of <0.05 was considered significant.</p><p><strong>Results: </strong>The sample included 48 subjects. The mean age of all subjects was 43 ± 24 years. Overall, 42 (87.5%) cases were successful. The perioperative antibiotic administered (<i>P</i> = 0.02), etiology (<i>P</i> = 0.021), and the addition of platelet rich fibrin or autograft as an adjunct influenced CBM success (<i>P</i> = 0.039).</p><p><strong>Conclusions: </strong>CBMs are a viable option for reconstruction of maxillary bone defects. CBMs may be an alternative to autografts.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP263-NP270"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a Structured Trauma Template in Improving Clinical Examination Accuracy in Maxillofacial Trauma: A Prospective Study.","authors":"Akhilesh K Pandey, Gigi Pg, Harshitha Rajanna, Abhishek Anil, Pravin Kumar, Ankita Chugh","doi":"10.1177/19433875241272435","DOIUrl":"10.1177/19433875241272435","url":null,"abstract":"<p><strong>Study design: </strong>Prospective pre-post study.</p><p><strong>Objective: </strong>Maxillofacial trauma presenting to the emergency department (ED) are often accompanied with complex concomitant injuries, thereby making thorough diagnosis and treatment plan quite an exacting task owing to the demanding conditions of the ED. The use of a structured maxillofacial trauma template helps in documenting the injuries comprehensively, aids in treatment planning, avoids medical negligence thereby improving the quality of care given to the patient. The study introduced a structured maxillofacial trauma template to improve the quality of the ED documentation.</p><p><strong>Methods: </strong>A total of 220 patients were evaluated for the quality of their ED documentation from September 2023 till February 2024. The group A included 110 patients where complete medical documentation was done routinely on a blank A4 sized paper, group B included 110 patients where the documentation was done using the structured oral and maxillofacial trauma template. The ED notes were thoroughly evaluated by the 2 independent authors for record completeness and documentation rate of history and examination findings.</p><p><strong>Results: </strong>The introduction of trauma template demonstrated a significant improvement of 18.95 % in record completeness. Significant improvement was seen in documentation rate among the covariates like place of injury, time of evaluation, primary care given, wound classification, dento-alveolar injury, ophthalmic evaluation, nerve injury evaluation, comorbidities with <i>P</i> = .001, and referral with <i>P</i> = .03. The ophthalmic evaluation showed significant improvement among covariates (loss of visual acuity, reflexes, diplopia, enophthalmos, subconjunctival haemorrhage, chemosis, periorbital oedema, periorbital ecchymosis, ocular dystopia) with <i>P</i> = .001, and extraocular muscle restriction with <i>P</i> = .004.</p><p><strong>Conclusions: </strong>The study demonstrated that the use of a structured oral and maxillofacial trauma template can significantly improve the quality of the ED documentation and contributes to better patient care in the ED.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP204-NP216"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the Potential of Submental Intubation - Redefining Airway Management in Craniomaxillofacial Trauma Patients.","authors":"Amit Dharamvir Mahajan, Sharvari Prakash Daithankar, Pratesh Nitin Dholabhai, Aniruddh Pratap Singh, Aditya Rajesh Shah, Nirvani Pinkesh Shah","doi":"10.1177/19433875241278797","DOIUrl":"10.1177/19433875241278797","url":null,"abstract":"<p><strong>Study design: </strong>Submental intubation is and underutilized alternative to traditional techniques of intubation. Complications associated can indeed deter surgeons and anesthesiologist from performing it. Surgeons may opt for submental intubation if they believe that its advantages outweigh the potential risks of the procedure. Identifying the reasons of complications and implementing of proper strategies to address them can help mitigate risks.</p><p><strong>Objective: </strong>This study aims to compare and analyze the complications experienced during and after submental intubation to comment on its safety, efficacy. Revisiting literature, will help us to comment on diagnosis in trauma and associated perioperative and intraoperative complication with it. It will also help us deduce most preferred way of performing submental intubation and various methods to manage complications.</p><p><strong>Methods: </strong>Submental intubation in patients experiencing craniofacial trauma was reviewed retrospectively for 9 years from January 2015 to August 2023. Common diagnosis sites were analyzed for perioperative and postoperative complications.</p><p><strong>Results: </strong>It was found that there were no much complications faced perioperatively and also notes methods used for management of complications. Most commonly encountered postoperative complication was scar. Literature of past years was reviewed, during process we also came out with novel method for safe extubation for which we have got copyright from Government of India.</p><p><strong>Conclusions: </strong>Submental intubation is a safe and efficient intraoperative airway management technique for patients with craniomaxillofacial injuries when there is concurrent facial trauma. This study findings would underscore the safety and efficacy of SEI, making it a promising unparalleled method of airway management worth considering.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP230-NP241"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Characterization of Facial Lacerations in Emergency Departments in the United States.","authors":"Heather Peluso, Kevin Vega, Sthefano Araya, Lindsay Talemal, Civanni Moss, Jake Siegel, Adam Walchak","doi":"10.1177/19433875241257572","DOIUrl":"10.1177/19433875241257572","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Study design: &lt;/strong&gt;This is a retrospective study using the Nationwide Emergency Department Sample.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Facial laceration repairs are one of the most common procedures performed in the emergency department (ED). The goal of this study was to describe the patient's characteristics and healthcare cost associated with ED encounters for facial lacerations using the largest nationally representative database in the United States.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a retrospective study using the Nationwide Emergency Department Sample. The data was collected between January and December of 2019. Patients with either a primary or secondary diagnosis of facial laceration were included. The primary outcome was patient characteristics. The secondary outcomes were ED characteristics, number and type of procedures performed and total encounter charges. Diagnoses and procedures were identified using ICD-10 CM codes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 2,548,944 ED encounters for facial lacerations in the United States. Of those, laceration was the chief complaint in 75%. 80% of lacerations were unintentional, 8% were due to assaults, and &lt;1% due to suicidal attempts. The most common laceration location was the scalp (21%) followed by the lip (11%) and eyelid (11%). The mean patient age was 38 years. Most patients were adults (69%), male (62%), Caucasian (64%, African American 14%, Hispanic 14%, Other 4%, Asian 2%), from low income levels ($1-$45,999: 29%, $46,000- $58,999: 24%, $59,000-$78,999: 24%, $79,000 or more: 23%), with private insurance (32%, Medicaid 25%, Medicare 24%, self-pay 12%, other 6%). Most encounters were during summer (June, July, August) at large metropolitan areas with at least 1 million residents (52%, small metropolitan: 30%, micropolitan: 10%, other: 7%) at teaching hospitals (65%) located in the southern region of the United States (37%, Midwest: 23%, west: 21%, northeast: 19%). Almost half of the encounters were at non-trauma-designated hospitals (48%, Level 1 trauma center: 21%, Level 2 trauma center: 17%, Level 3 trauma center: 13%). The number of procedures during each encounter was: none: 4%, one: 17%, two: 23%, three: 11%, four: 11%, five or more: 28%. The most frequent laceration repair was a simple repair of superficial wounds of the face, ears, eyelids, nose, lips, and/or mucous membranes 2.5 cm or less, followed by simple repair of superficial wounds to the scalp, neck, axillae, external genitalia, trunk, and/or extremities 2.5 cm or less. Most emergency department visits were billed as a Level 3 encounter, followed by Level 2 then Level 4. CT scan of the head was the most common imaging modality. Of all patients, &lt;1% were admitted to the hospital and 87% were discharged home. The average total emergency department charges were $5,733.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Facial laceration is a common complaint in the emergency department. It is costly, and disproportion","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":" ","pages":"NP113-NP120"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11563022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}