Maxillofacial surgery in wartime Middle-East: Paul Tessier's missions to Iran |
| |
| Affiliation: | 1. Assistance Publique - Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service de Chirurgie Maxillo-Faciale et Chirurgie Plastique, Paris, France;2. Centre de Référence Maladies Rares MAFACE, Filière Maladies Rares TETECOU, Paris, France;3. Université Paris Descartes, Université de Paris, Paris, France;4. Assistance Publique - Hôpitaux de Paris, Hôpital Universitaire Necker - Enfants Malades, Service d’Oto-rhino-laryngologie et Chirurgie Cervico-faciale, Paris, France;5. Centre de Référence Maladies Rares MALO, Filière Maladies Rares TETECOU, Paris, France;6. Service de Chirurgie Maxillo-Faciale, Centre Hospitalier Universitaire Amiens-Picardie, Amiens, France;7. 26 Avenue Kléber, 75116, Paris, France;1. Department of Pediatric Plastic Surgery, Jichi Children''s Medical Center Tochigi, 3311-1, Yakushiji, Shimotsuke, 329-0498 Tochigi, Japan;2. Department of Plastic Surgery, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke, 329-0498, Tochigi, Japan;3. Lilla Craniofacial Clinic Tokyo, 1-7-17, Ginza, Chuo-ku, 104-0061, Tokyo, Japan;4. Department of Pediatric Neurosurgery, Jichi Children''s Medical Center Tochigi, 3311-1, Yakushiji, Shimotsuke, 329-0498, Tochigi, Japan;5. Department of Plastic Surgery, Shizuoka Children''s Hospital, 860, Urushiyama, Aoi, Shizuoka, 420-8660, Shizuoka, Japan;1. Posnick Center for Facial Plastic Surgery, Clinical Professor of Surgery and Pediatrics, Georgetown University, Washington, DC, USA;2. University of Maryland School of Dentistry, Baltimore, MD, USA;3. Howard College of Dentistry, Washington, DC, USA;4. Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA;5. Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA, USA;6. Posnick Center for Facial Plastic Surgery; Chevy Chase, MD, USA;1. Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria;2. Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria;3. Department of Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria;4. Department of Anaesthesia, College of Medicine, University of Ibadan, Ibadan, Nigeria;1. Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, Haifa, 31096, Israel;2. Department of Nuclear Medicine, Rambam Medical Center, Faculty of Medicine, Rappaport Family Institute for Research in the Medical Sciences, Technion - Israel Institute of Technology, Haifa, 31096, Israel |
| |
| Abstract: | The Iraq–Iran war (1980–88) resulted in numerous maxillofacial injuries. More than 400,000 people were wounded and required specialist care. Paul Tessier, a leading French plastic surgeon and pioneering craniofacial surgeon, was involved in several missions to Iran and operated on a vast cohort of patients with complex war trauma sequelae.Our study included 322 files relating to patients with war injuries operated on by Paul Tessier in Iran from 1990 to 1993. The files were the property of the Association Française des Chirurgiens de la Face. Relevant epidemiological parameters and data on surgical indications and procedures were collected. Descriptive statistics were used in order to characterize the cohort, and a multivariate logistic model was developed in order to assess factors associated with severe eye injuries within all facial injuries.Age range at admission was 5–67 years (average: 27.15 ± 6.97). The most common trauma mechanisms were shell fragments (161 patients; 50 %) and bullets (27 patients; 8.38 %). The bone and orbital contents in the upper third of the face were affected in 124 patients (38.50%); 72 patients (22.36%) had trauma of the middle third of the face; and 86 patients (26.71%) had trauma of the lower third. A total of 175 bone grafts were harvested by Tessier: 72 (41.14%) iliac grafts and 94 (53.71%) frontal and/or parietal grafts. Tessier managed 60 orbital fractures (18.63%) and 95 patients with uni- or bilateral enucleations (29.50%). A multivariate logistic model showed that patients injured by shells were 4.04 (1.32; 17.60) more likely (p = 0.03) than patients with gunshot wounds to have had uni- or bilateral enucleation, regardless of age and gender.Tessier's files provide first-hand information on the injury patterns that resulted from a regional war in the 1980s, and on the reconstruction challenges faced by a country during its post-war recovery period. |
| |
| Keywords: | War injuries Ballistic trauma Iraq–Iran Facial reconstruction War surgery |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
