Epidemiology and Management of Facial Soft Tissue Trauma in Calabar, Southern Nigeria

Ozinko M.O., Bassey G.O., Otei O.O., Ekpo R.G., Mgbe R.B.

Background: Facial soft tissue trauma is a common emergency condition encountered in our Accident and Emergency Department. Aim: several protocols have been adopted in the management of facial injuries; this paper reveals our adopted protocol that works for us as well as the associated epidemiology of facial soft tissue injuries. Methodology: All patients recruited into the casualty department except patients with burn cases were used for this study. Patients were demographically evaluated and their wounds categorized according to their complexity, sites and associated injuries. Management of injuries was in accordance to the American Trauma Life Support (ATLS). The wounds were debrided and treated according to the structures involved. They were managed and discharged with an average of 9months follow- up period. Some minor complications such as wound infection and scarring were noted. Results: 2016 soft tissue injuries in 1653 were seen in patients from between January and December, 2014, 104(9%) were associated with facial injuries. The sites of the face involved were the frontal area 41(39%), the cheek 24(22.9%), the nose 18(17.1%), the chin 11(10.5%), the eyelids 6(5.7%) and the lips 5(4.7%). The injuries were contusions, lacerations, abrasions and avulsions. About 28 cases, representing 26.9%, had fractures of the mandible, maxilla and the frontal bones as well as fracture- dislocation of the temporo-mandibular joints. 22% had various forms of head injuries. Aetiologically, road traffic accidents constituted 44(45%), falls 42(43.7%), sports 6(6.2%), human bites 6(6.2%) and gunshot injuries 2(2.2%). Fifteen deaths were recorded which were due to massive haemorrhage, airway obstruction and severe head injury. Conclusion: The adoption and application of our management protocol in the management of facial soft tissue injuries has greatly improved the outcome of treatment of facial soft tissue injuries in our facility.