A 17-year-old patient with facial trauma
was transferred to Nanavati Super
Speciality Hospital from a peripheral
hospital. Initial assessment of the
patient in the Emergency Department
reported that the patient was stable.
CT scan revealed facial bone fractures,
however, no head injury or respiratory
distress was detected. There was also no
bodily injury. At the time of admission,
she had a dressing on the left side of her
face and a slab on the right forearm.
The patient was admitted to the
CCU and was immediately started
on antibiotics and analgesics. A full
investigation of profile was scheduled.
The patient also suffered from edema,
and the left side of the face had drooped
down with a large gamgee wrapped
across the head like a turban.
The initial look of the patient showed a
degloved left side face completely black
and containing gravels. A lot of tissues
were also missing in the cheek and
temple region. An immediate bedside
wash was given, and the patient was
posted for debridement and closure.
The patient was given tetglob and
aggs cover. Debridement and immediate
reconstruction were the most challenging
decision; however, early management
proved to be a preferable choice.
It took more than an hour to remove
each and every speck of gravel from
“When the patient was
brought to the hospital,
she had suffered a major
facial trauma and the
left side of her face had
drooped down. No bodily
injury was recorded."
the nook and cranny of orbit pterygoid
fossa skin subcut lower lid and
The face back was suspended to the
zygomatic arch and temporalis fascia
to close a large tissue defect partially.
The patient also had a right forearm
circumferential degloving injury. After a
few days, the temple and forearm were
grafted along with facial bone fracture
plating to restore shape and occlusion.
Together with Dr. Anshuman Manasvi
– Consultant, Plastic Surgeon, the team
was ultimately able to provide her with
a decent reconstruction.
The patient was discharged following
a progressive recovery but will require
further interventions in the future to
remove the small area of graft in the left