Epidemiology and management of life-threatening hemorrhage secondary to maxillofacial injuries: Analysis of 14 cases in a Nigerian tertiary care center

Otasowie D Osunde, Godwin O Bassey

African Journal of Trauma 2016 5(1):5-9

Background: Life-threatening hemorrhage from the maxillofacial region is a rare occurrence. In this study, the management of maxillofacial patients with life-threatening acute blood loss in a Nigerian tertiary health care facility is presented. Materials and Methods: Data on the management of all consecutive patients who presented to the Accident and Emergency department of our institution with life-threatening hemorrhage arising from trauma to the oral and maxillofacial region were prospectively collected over a 4-year period. The information obtained included demographics, etiology, vital signs at presentation, interval between injury and presentation, nature and mechanism of injury, sources of bleeding, treatment done, postoperative follow-ups, and outcome. The data were analyzed using the Statistical Package for Social Sciences (SPSS version 13, SPSS Inc, Chicago, Illinois, USA). Statistical significance was set at a P < 0.05. Results: Fourteen patients (males = 12; female = 2) with age ranging from 17 to 65 years, mean 29.8 ± 12.82 years were managed within the study period. Majority of the victims were students (n = 7; 50%), and assault (n = 6; 42.9%) and road traffic accidents (n = 5; 38.5%) were the dominant modes of injury. The source of intraoral bleeding was from fractured mandible (n = 2) and lacerated tongue. The time interval between injury and time of presentation at treatment center ranged from 50 min to 1380 min (about 23 h), with a mean time interval of 275.1 ± 446.02 min. Ligation of the bleeder vessels combined with suturing of lacerations (n = 10; 71.4%) was the most common methods of arrest of hemorrhage in affected patients. Three of the patients required transfusion of whole blood plus intravenous infusion of crystalloids. The other eleven cases received only crystalloids. Conclusion: Early presentation achieved by prompt referral to a health facility with the requisite workforce and facility will bring about good treatment outcome and avoid preventable deaths.

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2gKNUYY