Self-inflicted gunshot wounds to the face: a review of 18 cases.

A 9-year experience at the University of New Mexico affiliated hospitals involving 18 patients with self-inflicted gunshot wounds to the face is reviewed. Almost all were young males, averaging 27.9 years of age. Fourteen patients were Native American, six from the same pueblo. Four shootings were 'accidental' and the rest suicidal. Sixteen patients were intoxicated at the time of injury. Interpersonal conflict with an important female and acculturation difficulties were thought to play major roles. Rifles were most commonly used, and injuries tended to be severe. High muzzle velocity (greater than or equal to 2,000 ft/sec), high muzzle energy (greater than or equal to 2,000 ft-lbs) weapons tended to be the most injurious, and low muzzle energy (less than or equal to 1,000 ft-lbs) guns were related to a lesser extent of injury regardless of muzzle velocity. Patient compliance during reconstruction has been excellent, and functional return to society with gainful employment and a stable marriage has been the rule. Subsequent suicide attempts have been uncommon.