medigraphic.com
ISSN 1561-297X (Print)

2018, Number 3

<< Back Next >>

Rev Cubana Estomatol 2018; 55 (3)

Procedures for initial management of maxillofacial polytrauma and severe maxillofacial trauma

Morales ND, Aguila NY, Vila MD

Language: Spanish
References: 30
Page: 1-15
PDF size: 123.89 Kb.


ABSTRACT

Introduction: facial fractures are a common cause of treatment in emergency services.
Objective: Describe procedures used and deaths occurring in the initial management of maxillofacial polytrauma and severe maxillofacial trauma at the emergency service.
Methods: a descriptive study was conducted of procedures used and deaths occurring among maxillofacial polytrauma and severe maxillofacial trauma patients cared for at the emergency service of General Calixto García University Hospital. The variables considered were both quantitative and qualitative. A data collection form was developed and the information was stored in a database. Data were expressed in whole numbers, percentages and statistical tables. Ethical research principles were abided by.
Results: 100 % of the patients underwent airway evaluation, and causes of exsanguination were searched for. Primary assessment: 70.3 % required some airway procedure and more orotracheal intubation was used (10.8 %); for circulation, more peripheral venous cannulation was performed, as well as volume administration and blood sampling for hematological testing (17.6 %). Secondary assessment: 16.2 % required orotracheal intubation; for circulation, 83.8 % required some procedure. 33.8 % needed suturing; CAT scanning was more commonly used (41.9 %). 12.2 % of the patients died; traffic accidents accounted for 9.5 %.
Conclusions: all patients underwent airway evaluation, and causes of exsanguination were searched for. The order in which procedures were used was variable, not phased according to the growing complexity of the procedures, and not all procedure options were used. Most deceased patients had been involved in traffic accidents.


REFERENCES

  1. Castillo Payamps RA, Escalona Cartaya JA, Pérez Acosta JR, Rodríguez Fernández Z. Algunas especificidades concernientes al paciente politraumatizado grave. Rev Cubana Cir [Internet]. 2016 [citado 2017 Mar 08];55(3):220-33. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 74932016000300004&lng=es 2Moore L, Champion H, O'Reilly G, Leppaniemi A, Cameron P, Palmer C, et al. Impact of trauma system structure on injury outcomes: a systematic review protocol. Syst Rev. 2017;6:12.

  2. DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Maxillofacial emergencies: Maxillofacial trauma. Emerg Med Australas. 2014;26:530-7.

  3. Coppola S, Froio S, Merli G, Chiumello D. Maxillofacial trauma in the emergency department: pearls and pitfalls in airway management. Minerva Anestesiol. 2015;81:1346-58.

  4. Glasheen J, Hennelly D, Cusack S. Maxillofacial Injury-Not Always a Difficult Airway. Prehosp Disaster Med. 2015;30(4):421-4.

  5. Barak M, Bahouth H, Leiser Y, El-Naaj IA. Airway Management of the Patient with Maxillofacial Trauma: Review of the Literature and Suggested Clinical Approach. Biomed Res Int. 2015;2015:724032.

  6. Jose A, Nagori SA, Agarwal B, Bhutia O, Roychoudhury A. Management of maxillofacial trauma in emergency: An update of challenges and controversies. J Emerg Trauma Shock. 2016;9(2):73-80.

  7. Yumoto T, Matsumura T, Tsukahara K, Sato K, Ugawa T, Ujikec Y. A case of cricothyroidotomy for facial trauma in a patient taking antiplatelet agents after a simple ground-level fall. Int J Surg Case Rep. 2016;27:87-9.

  8. Morales Navarro D, Vila Morales D. Atención inicial al politraumatizado maxilofacial: evaluación de la vía aérea y la circulación. Rev Cubana Estomatol [revista en Internet]. 2015 [citado 2017 Feb 28];52(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 75072015000300009&lng=es&nrm=iso&tlng=es

  9. Spahn DR, Bouillon B, Cerny V, Coats TJ, Duranteau J, et al. Management of bleeding and coagulopathy following major trauma: an updated European guideline. Crit Care. 2013;17(2):R76.

  10. Poole D, Cortegiani A, Chieregato A, Russo E, Pellegrini C, De Blasio E, et al. Blood Component Therapy and Coagulopathy in Trauma: A Systematic Review of the Literature from the Trauma Update Group. PLoS ONE 2016;11(10):e0164090.

  11. Lee W, Shim YS, Chung J. Endovascular Treatment to Stop Life-threatening Bleeding from Branches of the External Carotid Artery in Patients with Traumatic Maxillofacial Fracture. J Cerebrovasc Endovasc Neurosurg. 2016;18(2):83-9.

  12. Domínguez Perera MA, Camacho Tenorio S. Evaluación inicial del politraumatizado. En: Caballero López A. Terapia Intensiva. La Habana: Editorial Ciencias Médicas; 2009.

  13. Tapia NM, Suliburk J, Mattox KL. The Initial Trauma Center Fluid Management of Penetrating Injury: A Systematic Review. Clin Orthop Relat Res. 2013;471(12):3961-73.

  14. Hallet J, Lauzier F, Mailloux O, Trottier V, Archambault P, Zarychanski R, et al. The use of higher platelet: RBC transfusion ratio in the acute phase of trauma resuscitation: a systematic review. Crit Care Med. 2013;41(12):2800-11.

  15. Leonard E, Curtis K. Are Australian and New Zealand trauma service resources reflective of the Australasian Trauma Verification Model Resource Criteria? ANZ J Surg. 2014;84(7-8):523-7.

  16. Morales Navarro D, Vila Morales D. Atención inicial al politraumatizado maxilofacial: evaluación, conducta terapéutica y prevención. Rev Cubana Estomatol [revista en Internet]. 2015 [citado 2017 Feb 28];52(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034- 75072015000300010&lng=es&nrm=iso&tlng=es

  17. ELFiky I, El Sammak DAEA, El Sammak A, Abdelhady M. Diagnostic performance of multi-slice computed tomography using 2D and 3D images in the assessment of Le Fort fractures. The Egyptian Journal of Radiology and Nuclear Medicine. 2017;48(2):415-24.

  18. Noorbhai MA, Cassimjee HM, Sartorius B, Muckart DJJ. Elevated international normalised ratios correlate with severity of injury and outcome. SAMJ, S Afr Med J [Internet]. 2016 [citado 2017 Feb 22];106(11):1141-5. Disponible en: http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256- 95742016001100028&lng=pt

  19. Durante Alvarez B, Mardegam Razente D, Mauad Lacerda DA, Silveira Lother N, Von-Bahten LC, Martinez Menini Stahlschmidt C. Analysis of the Revised Trauma Score (RTS) in 200 victims of different trauma mechanisms. Rev Col Bras Cir [Internet]. 2016 [citado 2017 Feb 21];43(5):334-40. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100- 69912016000500334&lng=pt

  20. Cabalag MS, Wasiak J, Andrew NE, Tang J, Kirby JC, Morgan DJ. Epidemiology and management of maxillofacial fractures in an Australian trauma centre. J Plast Reconstr Aesthet Surg. 2014;67(2):183-9.

  21. Crönlein M, Holzapfel K, Beirer M, Postl L, Kanz K-G, Pförringer D, et al. Evaluation of a new imaging tool for use with major trauma cases in the emergency department. BMC Musculoskelet Disord. 2016;17:482.

  22. Gupta B, Prasad A, Ramchandani S, Singhal M, Mathur P. Facing the airway challenges in maxillofacial trauma: A retrospective review of 288 cases at a level I trauma center. Anesth Essays Res. 2015;9(1):44-50.

  23. Morales Navarro D, Vila Morales D. Aspectos generales del trauma maxilofacial. Rev Cubana Estomatol [revista en Internet]. 2016 [citado 2017 Feb 28];53(3). Disponible en: http://www.revestomatologia.sld.cu/index.php/est/article/view/790

  24. Scheyerer MJ, Döring R, Fuchs N, Metzler P, Sprengel K, Werner CML, et al. Maxillofacial injuries in severely injured patients. J Trauma Manage Outcomes. 2015;9:4.

  25. MINSAP. Dirección de registros médicos y estadísticas de salud. Anuario Estadístico de Salud 2015. [citado 2017 Mar 8]. Disponible en: http://files.sld.cu/dne/files/2016/04/Anuario_2015_electronico-1.pdf

  26. Udeabor S, Akinmoladun VI, Olusanya A, Obiechina A. Pattern of Midface Trauma with Associated Concomitant Injuries in a Nigerian Referral Centre. Niger J Surg. 2014;20(1):26-9.

  27. Díaz Fernández JM, Rodríguez Ricardo MA. Perfil de gravedad lesional en el politraumatismo maxilofacial. MEDISAN [Internet]. 2014 [citado 2017 Mar 8];18(5):660-71. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S1029- 30192014000500010&lng=es

  28. Díaz Fernández JM, Díaz Cardero AL. Perfil de severidad lesional del trauma esquelético maxilofacial. MEDISAN [Internet]. 2014 [citado 2017 Mar 8];18(7):954- 61. Disponible en: http://scieloprueba.sld.cu/scielo.php?script=sci_arttext&pid=S1029- 30192014000700011&lng=es

  29. Díaz Fernández JM, Inclán Acosta A. Perfil clinicoepidemiológico del politrauma maxilofacial. MEDISAN [artículo en Internet]. 2014 [citado 2014 nov 15];18(3). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1029- 30192014000300004&lng=es&nrm=iso&tlng=es

  30. Roy N, Veetil DK, Khajanchi MU, Kumar V, Solomon H, Kamble J, et al. Learning from 2523 trauma deaths in India- opportunities to prevent in-hospital deaths. BMC Health Serv Res. 2017;17:142.




2020     |     www.medigraphic.com