FACIAL TRAUMA

Facial trauma is injury to the face. This can result in lacerations (cuts and wounds), contusions (bruises), fractures (broken bones) and dental injuries to the teeth. The common causes of facial trauma are falls, accidental injuries, sports injuries and motor vehicle accidents.

Lacerations will usually need to be surgically repaired in order to obtain optimal healing and scarring. Contusions on their own do not normally require surgical treatment. Fractures of the facial bones, which commonly involve the cheek bone, eye socket, or jaws  require surgical treatment if the bones are displaced and out of alignment.

The most common type of facial injury we deal with is facial lacerations in children and adults. They usually occur on the upper part of the face, especially around the eye area. Adult patients and the parents of young patients are often very concerned about facial lacerations because of the scars that will result from these injuries. Therefore, it is important to repair these wounds to a high technical standard so that the resulting scars are as fine and inconspicuous as possible.

The complexity of repairing facial lacerations depends on the nature of the injury. The type of wound can range from simple linear and clean cuts with smooth edges to complex wounds that consist of multiple cuts that join each other at different angles and that are also oblique to the skin surface, making the repair more complicated and technically demanding. Often, these complex lacerations also have irregular and ragged wound edges and may be associated with abrasions of the involved skin, making repair and subsequent healing even more challenging.

Nevertheless, there are numerous plastic surgery techniques of wound repair and surgical aftercare that when applied, can result in good quality scars for these unfortunate patients. 

Repair of facial lacerations can be performed under local anesthesia, intravenous sedation or general anesthesia as required and appropriate. Children usually require general anesthesia as their young age means that being awake while undergoing a surgical procedure under local anesthesia becomes a psychologically and emotionally traumatic experience. Furthermore, it is highly likely that the child will struggle and not keep still during the procedure if it is attempted to be undertaken under local anesthesia. This will make it difficult for the surgeon to perform the repair optimally. General anesthesia, which has a high level of safety even in pediatric age groups, is therefore a kinder option for the child’s sake, and it ensures that the surgeon can apply all the necessary surgical techniques and complete the repair under optimal conditions. Laceration repair is usually a day surgery procedure that does not require hospitalization.

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