Maxillofacial and associated injuries in severely traumatized patients: implications of a regional survey.

The aim of this paper was to study the incidence and causes of facial injuries occurring in conjunction with major trauma, and to examine the role of the maxillofacial surgeon in the management of severely injured patients. A prospective study was undertaken of 1088 patients seen in 16 hospitals over a 1-year period. A total of 161 (15%) patients sustained facial injuries. Of these, 33% died at the scene of the incident and 21% died in hospital. There was poor resuscitation in 32% of patients, and a total of 32 injuries were missed in 19 patients. The involvement of the maxillofacial surgeon in the management of severely injured patients is examined. Our findings emphasize the need for early referral to the maxillofacial surgeon. It is concluded that maxillofacial surgery should be an on-site speciality, closely associated with the neurosurgical centre.