Bear attack injury to maxillofacial region: Report of 3 cases and review of management

Taphonomic-forensic analysis of the hominin skulls from the Sima de los Huesos

The Sima de los Huesos (SH) hominin assemblage is composed of thousands of fossil fragments, including pieces of crania and mandibles. The main objective of this work is to address the main taphonomic features of the cranial and mandibular remains from the SH sample, including antemortem, perimortem, and postmortem skeletal disturbances. We present an updated assessment of healed cranial trauma, first described in 1997 and now including new skulls. In addition, this study reviews the perimortem fractures in relation to their location and features of the affected individuals. Finally, this paper deals with the modifications affecting the cranial sample from the SH at the postmortem stage, including physical and biological postdepositional modifications. The SH collection provides a unique opportunity for conducting a complete forensic-taphonomic study on a Middle Pleistocene population.

Risk factors associated with infection in patients sustaining dog bites to the face

PURPOSE

The purpose of this study is to identify which patient-level factors, if any, influence the risk of infection following dog bite wounds to the face.

MATERIALS AND METHODS

This retrospective cohort study was conducted using the Kids' Inpatient Database (KID). The primary predictor variable was the type of facial injury. The primary outcome variable was the presence of facial infection. SPSS was used to perform statistical analyses and statistical significance was set at a P-value of < 0.05.

RESULTS

Our final sample comprised a total of 4,420 patients who suffered dog bites to the face, of which 1,237 (28.0%) resulted in infection. Open wound (n = 4,176, 94.5%) was the most common facial injury, followed by bone fractures (n = 105, 2.4%). Relative to children 16-20 years old, children who were 0-5 years old were three times more likely to develop an infection (P < 0.01). Finally, open wounds (P < 0.01) were over seven times more likely to get infected relative to fractures.

CONCLUSIONS

Young children, particularly those below the age of five, are vulnerable to dog bite wounds to the face. Open wounds posed the greatest risk of getting infected.

Head and neck injuries after leopard attack: Presentation and management

Leopard attacks on humans are reported most often from the Indian subcontinent. The bite wounds are complex injuries infected with polymicrobial inoculum and may present as punctures, abrasions, lacerations or avulsions. The presentation and acceptable treatment of these injuries vary according to the wound. We hereby describe the clinical presentation and treatment of a male victim with leopard bite injuries on the head and neck region. As bite injuries are commonly found on and around the face, maxillofacial surgeons should be familiar with the therapy. Through thorough clinical and radiological examination, it is essential to prevent missing any hidden injuries, which can easily turn lethal. To benefit the rural population, more health facilities need to be established in remote areas.

Management of extensive maxillofacial injury related to a Tyre Blast: A rare case report

Background

Severe blast injuries of large tyres are similar to those resulting from explosions with neither thermal nor chemical effects. The literature related to the destructive nature of these blasts is very sparse. This case aims to report the clinical management of a patient involved in large tyre blasts who presented with a severe soft tissue injury, comminuted mandible and associated multiple facial fractures due to a tyre blast injury.

Results

Excellent results were obtained following reduction and fixation of fractures with primary suturing, as these types of injuries are prone to infection secondarily.

Conclusion

Due to the etiology and severity of injury, these injuries are challenging to operate and are more prone to infection following surgery. These require careful management skills.

Effect of Irrigation Time of Antiseptic Solutions on Bone Cell Viability and Growth Factor Release

Antiseptic solutions are commonly utilized to treat local infection in the oral and maxillofacial region. However, surrounding vital bone is also exposed to antiseptic agents during irrigation and may have a potential negative impact on bone survival. The aim of the present study was therefore to investigate the effect of rinsing time with various antiseptic solutions on bone cell viability, as well as their subsequent release of growth factors important for bone regeneration. The bone samples collected from porcine mandible were rinsed in the following commonly utilized antiseptic solutions; povidone-iodine (0.5%), chlorhexidine digluconate (CHX, 0.2%), hydrogen peroxide (1%), and sodium hypochlorite (0.25%) for 1, 5, 10, 20, 30, or 60 minutes and assessed for cell viability and release of growth factors including vascular endothelial growth factor, transforming growth factor beta 1, bone morphogenetic protein 2, receptor activator of nuclear factor kappa-B ligand, and interleukin-1 beta by enzyme-linked immunosorbent assay. It was found in all the tested groups that the long exposure of any of the tested antiseptic solutions drastically promoted higher cell death. Sodium hypochlorite demonstrated the significantly highest cell death and at all time points. Interestingly, bone cell viability was highest in the CHX group post short-term rinsing of 1, 5, or 10 minutes when compared with the other 4 tested groups. A similar trend was also observed in subsequent growth factor release. The present study demonstrated that of the 4 tested antiseptic solutions, short-term CHX rinsing (ideally within 1 minute) favored bone cell viability and growth factor release. Clinical protocols should be adapted accordingly.

Maxillofacial injuries due to animal bites

INTRODUCTION

Animal bites are a significant public health problem, with the majority of bites coming from dogs, cats and humans. These may present as punctures, abrasions, tears, or avulsions. The force and relative bluntness of the teeth also increases the possibility of a crush injury with devitalized tissue .The clinical presentation and appropriate treatment of infected bite wounds vary according to the animal and causative organisms. These wounds have always been considered complex injuries contaminated with a unique polymicrobial inoculum.

MATERIALS

This article reviews animal bite wound incidence, bacteriology, risk factors for complications, evaluation components, recommended treatment and prevention based on advanced PUBMED search of the English language literature from the years 1970 to present.

CONCLUSION

As the bite wounds are frequently located on the face, an oral and maxillofacial surgeon needs to be familiar with the treatment of animal bites, pitfalls in management and to educate patients on ways to avoid future bite injuries. The management of animal bites is an evidence poor area and most recommendations are based on small case series, microbiological data and expert opinion. The main controversies include whether wounds should or should not undergo primary closure and the use of prophylactic antimicrobials.