MINORS MANUAL
Facial injuries are wounds that affect the soft tissues (skin, muscles, blood vessels) of the face, and in some cases, may involve deeper structures such as bones, nerves, or tear ducts. Due to the rich vascularisation of the area, facial injuries tend to bleed profusely but also have a high healing capacity.
Diagnosis
The diagnosis of facial injuries is made through detailed visual inspection to assess the extent of the injury, its depth, the possible involvement of underlying structures, and the presence of foreign bodies. It is important to evaluate neurological functions (such as facial mobility) and the structures involved (such as the eyes, nose, and mouth).
Differential Diagnosis
Pathology | Key Characteristics |
|---|---|
Facial fractures | Bone deformity, crepitus, facial asymmetry |
Penetrating injuries | Involvement of deep structures, possible eye damage |
Facial haematomas or bruises | Ecchymosis, no discontinuity of the skin |
Skin infections (cellulitis) | Erythema, local heat, no history of acute trauma |
Emergency Management
Haemorrhage control: Direct pressure should be applied to the wound with sterile gauze to stop the bleeding. If the bleeding is severe, consider temporary suturing or clamping of bleeding vessels.
Airway assessment: In extensive or complex injuries, especially around the mouth or neck, ensure that the airway is not compromised.
Decontamination: Clean the wound with sterile saline solution to remove debris and foreign bodies. Remove devitalised tissue if necessary.
Suturing and closure: If the wound shows no signs of infection and the deeper structures are not compromised, perform primary closure, ideally within the first 6 to 12 hours.
Antibiotic prophylaxis: In contaminated wounds or those at risk of infection (e.g., bites or heavily soiled wounds), consider prophylactic antibiotics such as amoxicillin-clavulanic acid.
Definitive Treatment
Surgical closure by a specialist (plastic or maxillofacial surgeon) if deep structures such as bone, nerves, tear ducts, or major vessels are affected.
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