In search of excellence: establishing a routine of oromaxillofacial procedures for patients with polytrauma

International literature describes clear and objective criteria for the treatment of facial bone fractures and consequent lesions and recommends protocols, approach routines, reduction and fixation that may enhance the predictability of results. However, oromaxilofacial surgeons and trauma specialists, when working in emergency and trauma departments with patients with polytrauma, have to make decisions that directly depend on emergency protocols, and have to interact with other teams at different moments according to the severity and complexity of cases. Protocols for these procedures are not found in the literature. Patients with polytrauma often receive oromaxillofacial treatment later than recommended, which may complicate their recovery and increase the number of sequelae. The author, based on his experience in facial trauma and emergency, proposes a definition of treatments and a routine sequence of possible events according to the priority at each time, and defines them according to case complexity, clinical possibilities at each moment after trauma, and adaptation to international protocols, such as the ATLS system. His protocol defines five situations for the surgeon’s intervention when treating patients with polytrauma and facial trauma:

  • UT – Urgent treatment [Tratamento Urgência – TU];

  • IT – Immediate treatment [Tratamento Imediato – TI];

  • WT – (Watchful) waiting treatment [Tratamento Espera – TE];

  • DT – Definitive treatment [Tratamento Definitivo – TD];

  • ST – Sequela treatment [Tratamento Sequela – TS].

For each of these moments, indications, objectives and treatment have been defined. Particular features of each case should be taken into consideration to promote adjustments, establish norms to define severity and possible treatments and reduce unwanted results.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on In search of excellence: establishing a routine of oromaxillofacial procedures for patients with polytrauma
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