Resident Manual of Trauma to the Face, Head and Neck

III. Principles of Soft Tissue Wound Management ...........................36 A. Initial Wound Management...........................................................36 1. Cleansing.....................................................................................36 2. Debridement..............................................................................36 3. Passive Drains............................................................................36 4. IV Antibiotics and Tetanus Toxoid........................................36 5. Inspection and Documentation.............................................36 B. Primary versus Delayed Closure.................................................36 C. Laceration Care after Repair.........................................................36 1. Closing Clean Wounds Primarily. .........................................36 2. Avoiding Additional Incisions................................................ 37 3. Reconstructing the Facial Framework Early........................ 37 D. Bite Wounds..................................................................................... 37 IV. Principles of Plating .............................................................................38 A. Reconstructive Goals.....................................................................38 B. Technical Objectives......................................................................38 1. Stability at Each Fracture Site.................................................38 2. Three-Point Fixation of Mobile Segments..........................38 3. Bone Fragment Contact...........................................................38 C Plating Systems ..............................................................................38 1. Metal Plating..............................................................................39 2. Resorbable Plating....................................................................39 V. References and Resources ................................................................39 Frontal Sinus and Anterior Skull Base Trauma .............................41 A. Introduction.......................................................................................41 B. Classification....................................................................................42 C. Presentation......................................................................................43 1. Anterior Wall Fractures...........................................................43 2. Posterior Wall Fractures..........................................................43 3. Frontonasal Duct Fractures.................................................... 44 4. Corner Fractures ...................................................................... 44 5. Through-and-Through Fractures.......................................... 44 D. Management ...................................................................................45 1. Anterior Wall Fractures...........................................................45 2. Posterior Wall Fractures ........................................................ 46 3. Frontonasal Duct Fractures ....................................................47 4. Through-and-Through Fractures.......................................... 48 II. Naso-orbital-ethmoid Fractures ........................................................51 A. Anatomic Structures of the NOE Complex..............................52 B. Indications of Injury to the NOE Complex Structures...........53

Chapter 3: Upper Facial Trauma I.

Resident Manual of Trauma to the Face, Head, and Neck 2