Craniofacial trauma presenting at an adult accident and emergency department with an emphasis on soft tissue injuries.

We have retrospectively compiled data on 1000 consecutive adult patients presenting at an accident and emergency department (AED) with a total of 1048 soft tissue injuries and 151 fractures to the craniofacial region, with an emphasis on soft tissue injuries. Facial injuries were common in the AED, forming 7% of all attenders. The main cause of facial fractures was assaults (56%), whereas the largest proportion of soft tissue injuries was caused by falls/ accidents (44%). There was a left sided dominance in soft tissue injuries arising from assaults. However, when subdivided into type of soft tissue injuries, the left sided dominance was significant in contusions only, with virtually equal side distribution in open wounds. Almost half of the 458 open wounds which required treatment were in the upper third of the face. Most lacerations in the upper face can be managed by steristrips or glue but most lacerations in the lower third required suturing. 90% of these injuries were treated by AED personnel. Tertiary referrals were made in only 10% of these cases.