Abstract
Suicide by firearm remains one of the leading causes of violence-related injury death
in the United States each year. The mortality rate from these injuries is high, resulting
in a paucity of outcome data in the literature regarding injuries to the maxillofacial
region. This has largely been attributed to a lack of funding for research in this
area compared to other leading causes of mortality in the United States. The aim of
this study was to detail the authors’ experience and approach to complex maxillofacial
reconstruction using both local reconstructive methods and microvascular free tissue
transfer. A retrospective cohort study was designed, including patients who sustained
self-inflicted gunshot wounds to the maxillofacial region between January 1, 2012
and May 1, 2020. Forty-one patients met the inclusion criteria. The majority of the
patients were male (87.8%). Mean patient age was 44.2 ± 16.6 years. Alcohol or drugs,
and a psychiatric history were present in a majority of the cases. The most involved
anatomical region was the midface (75.6% of cases). Seven patients required free tissue
transfer for reconstruction, with many needing multiple flaps. Self-inflicted gunshot
wounds represent challenging reconstruction scenarios, often in the setting of severe
psychological trauma, and require a multidisciplinary team to ensure the optimal outcome.
Keywords
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Article info
Publication history
Published online: June 27, 2022
Accepted:
June 9,
2022
Identification
Copyright
© 2022 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
