A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments
Abstract Background Facial gunshot wounds present a complex challenge to both medical professionals and victims with significant physical, psychological, and economic implications for those who suffer these types of injuries. Reconstructive surgery offers satisfactory aesthetic and functional outcom...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | International Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12245-023-00572-3 |
| _version_ | 1797377199547875328 |
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| author | Luca Tomassini Giuliano Ascani Paolo Mancini Claudio Cacaci Roberto Scendoni |
| author_facet | Luca Tomassini Giuliano Ascani Paolo Mancini Claudio Cacaci Roberto Scendoni |
| author_sort | Luca Tomassini |
| collection | DOAJ |
| description | Abstract Background Facial gunshot wounds present a complex challenge to both medical professionals and victims with significant physical, psychological, and economic implications for those who suffer these types of injuries. Reconstructive surgery offers satisfactory aesthetic and functional outcomes, improving a patient’s quality of life. In these cases, the surgical procedure may encompass additional phases beyond those initially identified based on the type of wound and the extent of tissue destruction. As a result, each case necessitates thorough evaluation to determine an appropriate strategy. Nonetheless, it is worth noting that the outcomes achieved in terms of both aesthetics and functionality in this domain have the potential to be excellent. Case presentation A 66-year-old man attempted suicide with a shotgun, causing severe facial injuries and fractures. He had a history of depression and was taken to the emergency department promptly. CT scans revealed brain and facial bone injuries, and he underwent surgery to control bleeding and tracheostomy. Postoperative recovery was successful. The patient’s condition stabilized, and he was discharged after 10 days. Follow-up visits showed gradual healing. Despite an offer for further facial reconstruction, he declined, satisfied with the achieved results. Conclusions The present case report is intended to support the argument that effective facial reconstruction should be considered in the medico-legal assessment. It could be beneficial to introduce a new classification system and personalized evaluation methods with careful consideration given to treatment costs (which can be very high) and expected results. Since reconstructive surgery modifies damage and impacts the long-term costs of permanent impairments, its inclusion in the decision-making process would promote improved personalized care. |
| first_indexed | 2024-03-08T19:49:20Z |
| format | Article |
| id | doaj.art-6ab6006796fc40a590a75a2db9dd6575 |
| institution | Directory Open Access Journal |
| issn | 1865-1380 |
| language | English |
| last_indexed | 2024-03-08T19:49:20Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Emergency Medicine |
| spelling | doaj.art-6ab6006796fc40a590a75a2db9dd65752023-12-24T12:09:09ZengBMCInternational Journal of Emergency Medicine1865-13802023-12-011611710.1186/s12245-023-00572-3A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessmentsLuca Tomassini0Giuliano Ascani1Paolo Mancini2Claudio Cacaci3Roberto Scendoni4International School of Advanced Studies, University of CamerinoDepartment of Maxillofacial Surgery, Spirito Santo HospitalDepartment of Maxillofacial Surgery, Spirito Santo HospitalDepartment of Law, Institute of Legal Medicine, University of MacerataDepartment of Law, Institute of Legal Medicine, University of MacerataAbstract Background Facial gunshot wounds present a complex challenge to both medical professionals and victims with significant physical, psychological, and economic implications for those who suffer these types of injuries. Reconstructive surgery offers satisfactory aesthetic and functional outcomes, improving a patient’s quality of life. In these cases, the surgical procedure may encompass additional phases beyond those initially identified based on the type of wound and the extent of tissue destruction. As a result, each case necessitates thorough evaluation to determine an appropriate strategy. Nonetheless, it is worth noting that the outcomes achieved in terms of both aesthetics and functionality in this domain have the potential to be excellent. Case presentation A 66-year-old man attempted suicide with a shotgun, causing severe facial injuries and fractures. He had a history of depression and was taken to the emergency department promptly. CT scans revealed brain and facial bone injuries, and he underwent surgery to control bleeding and tracheostomy. Postoperative recovery was successful. The patient’s condition stabilized, and he was discharged after 10 days. Follow-up visits showed gradual healing. Despite an offer for further facial reconstruction, he declined, satisfied with the achieved results. Conclusions The present case report is intended to support the argument that effective facial reconstruction should be considered in the medico-legal assessment. It could be beneficial to introduce a new classification system and personalized evaluation methods with careful consideration given to treatment costs (which can be very high) and expected results. Since reconstructive surgery modifies damage and impacts the long-term costs of permanent impairments, its inclusion in the decision-making process would promote improved personalized care.https://doi.org/10.1186/s12245-023-00572-3Facial gunshot woundsReconstructive surgeryMedico-legal assessmentPermanent impairmentsCost of firearm injuries |
| spellingShingle | Luca Tomassini Giuliano Ascani Paolo Mancini Claudio Cacaci Roberto Scendoni A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments International Journal of Emergency Medicine Facial gunshot wounds Reconstructive surgery Medico-legal assessment Permanent impairments Cost of firearm injuries |
| title | A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments |
| title_full | A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments |
| title_fullStr | A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments |
| title_full_unstemmed | A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments |
| title_short | A case of emergency reconstructive surgery following facial destructive gunshot wounds: clinical and medico-legal assessments |
| title_sort | case of emergency reconstructive surgery following facial destructive gunshot wounds clinical and medico legal assessments |
| topic | Facial gunshot wounds Reconstructive surgery Medico-legal assessment Permanent impairments Cost of firearm injuries |
| url | https://doi.org/10.1186/s12245-023-00572-3 |
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