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Emergency War Surgery NATO Handbook: Part IV: Regional Wounds and Injuries: Chapter XXIII: Maxillofacial Wounds and Injuries

Initial Management

United States Department of Defense
Peer Review Status: Internally Peer Reviewed


The problems associated with maxillofacial injuries are similar to those of other injuries; that is, maintenance of the airway, control of hemorrhage, reduction of fractures, prevention of infection, and maintenance of fluid balance. Special problems arise because of mechanical interference with breathing and swallowing. A patent airway and an adequate fluid and nutritional intake are difficult to achieve in many maxillofacial injuries because of the partial or complete obstruction of the respiratory or alimentary orifices.

If patients with maxillofacial injuries require sedation, narcotics must not be used until it is certain that there is neither associated intracranial injury nor a marginal airway. Tracheostomy may be required.  

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