1、Oral&Maxillofacial TraumaChapter 72022-10-2312022-10-2322022-10-2332022-10-2342022-10-2352022-10-236(from Cambridge Advanced Learners Dictionary)2022-10-237IncidenceTraffic AccidentSportsFallingBustupLabor injury2022-10-23824万万14.2万人万人10亿元亿元1993年年1997年年2001年年30万万19万人万人18.5亿元亿元75.5万万54.6万人万人3.09b RMB
2、Financial Financial LossLoss致伤人数致伤人数No of traffic No of traffic accidentaccidentTraffic Accident2022-10-2392022-10-2310Effect of Trauma on the Human Body2022-10-23112022-10-2312Debridement Time:24 48 hTend to hematoma,edemaRespiratory tractAsphyxiaAbility to anti-infection,regenerationWound healing2
3、022-10-2313 Increase infectious incidence Malocclusion caused-Diagnosis Occlusion regained-Treatment2022-10-2314Mouth opening,mastication,swallowingBleedingParalysis瘫痪Leading difficulty breathingdietworse oral hygieneAsphyxia 窒息2022-10-2315 InfectionOral cavityNasal cavityPharyngeal cavityOrbitParan
4、asal sinusBacteriaTempHumidity2022-10-2316Parotid GlandFacial N.Trigeminal N.Salivary fistulaFacial paralysisRegional numbness2022-10-2317 Facial contour Psychological trauma2022-10-2318Evaluate trauma soonIdentify the key trauma,manage the fatal firstCareful history taking,thorough physical examRes
5、cue in timeManagement in orderGeneral Rules2022-10-23192022-10-2320Dysphoria,sweating,inhaling respirationDifficult to inhale,hypopnea,nasal alar movement,labial cyanosisThree concave signs、Rapid breathing,weak pulse,decreased BPPupils diluted,No reflection to lightProdrome2022-10-2321 Foreign body
6、obstructionInspiratory AsphyxiaLow AirwaySwellingForeign bodyBlood,salivaVomitUpper airwayTissue dislocation Obstructive Asphyxia2022-10-2322Clear foreign body in upper airwaySuspend maxillaIntubationHold the tongue outObstructive Asphyxia 吸入性窒息吸入性窒息气管切开术气管切开术2022-10-2323Two steps：Judge bleeding sit
7、uationChoose the way to stop bleeding2022-10-2324Three categoriesArterialCapillaryVenousBased on origin2022-10-2325压迫止血压迫止血指压止血法指压止血法包扎止血法包扎止血法填塞止血法填塞止血法结扎止血法结扎止血法药物止血法药物止血法2022-10-2326(2)Purpose of anti-shock(1)Definition&Classification Traumatic shockExsanguine shock 20%Body weightToxic shockInfec
8、tious shock Restore circulation2022-10-2327(4)Principles of Treatment (3)Features of ShockEarly stage:Dysphoria,quick&superficial breath,sweating,palenessMiddle stage:Tingle to supression,emotional faint,unconsciousness,decrease BP,labial palenessLate stage:weaker pulsation,unmeasurable BP,hyponuria
9、,anuria 30ml/hHemostasis,blood transfusion,pain control,fluid transfusion,sedation2022-10-2328(1)JudgementConsciousness,pulse,BP,respiration,pupil(2)Early discovery,early managementRetrograde obliviscenceCerebral concussionIntermediate wake-upExtradural hematomaCerebral fluid leakSkull base fracture
10、2022-10-23292022-10-2330DebridementWound closureAntibiotics2022-10-23312022-10-2332Abrasions 擦伤Contusions挫伤Contusions&Lacerations挫裂伤Incised&Puncture Wound切割伤及刺伤 Bite Wound 咬伤 Types of injuries2022-10-23331.Abrasions2022-10-23341.Abrasions2022-10-23352.Contusions2022-10-2336Property:Blunt object with
11、 high mechanical force3.Contusions&LacerationsCharacterlIrregular wound edge,saw-toothedlBig lacerationlw/wo necrotic tissue&open fracturesManagementl Debridementl Wound Closure2022-10-23373.Contusions&Lacerations2022-10-2338Property:Sharp object or instruments4.Incised&Puncture WoundCharater l Regu
12、lar wound edgel Bleedingl Small access,but deep woundManagementl Debridementl Wound closure2022-10-2339Property:Animal(Wolf,dog,Bear)or human beingsCharacterl Tooth tracedl Heavy contaminationl Tend to infectionManagementl Thorough debridementl Infection controll Skin graft after granular tissue reg
13、eneratedl Vaccination of Tetanus,Rabies5.Bite Wound2022-10-2340Debridement2022-10-23411.wash wound Time：6-12h Solution:soap water,saline,hydrogen dioxideDebridement3.Closure2.Clean wound Removal of foreign body Trimming of necrotic tissue2022-10-23422022-10-2343Management of soft tissure injuries202
14、2-10-2344Management of soft tissure injuries2022-10-23452022-10-23462022-10-23471.Tooth injuries 1.1 Contusion of TeethEtiology:Extrinsic force blunt tooth injuriesPeriodontal ligaments or dental pulpCharacter:l Extrusion of toothl Mobilityl Percussion&Toothache when chewingManagementl Tooth restl T
15、ooth groundl Simple ligation2022-10-23481.Tooth injuries 1.2 Luxation of TeethClassificationCharacterl Tooth dislocated or exfoliatedManagementl Tooth protection priorityl Reductionl Fixationl ReimplantationPartial luxationComplete luxation-Tooth dislocation-Semi luxation-Intrusive movement2022-10-2
16、349Gingival or labial swelling,lacerationAdjacent teeth or alveolar process movement when one affected tooth touchedFragment dislocation,MalocclusionIn accordance with tooth luxation or fracture2.Fracture of Alveolar ProcessCharacters2022-10-2350l Extrinsic force to dental alveolar process,mainly to
17、 upper jawl Reduction under LAl Arch bar applied2.Fracture of Alveolar ProcessEtiologyManagement 2022-10-23512.Fracture of Alveolar Process2022-10-2352Stainless steel wire ligation,Arch bars2022-10-23531.Describe the characteristics of OMF Trauma?2.Describe the etiology,clinical features and managem
18、ent of asphyxia.3.Describe the ways of hemastasis.4.What is debridement?5.Describe the common site of dental alveolar process fracture,and their clinical manifestation.2022-10-23541.LJ Peterson,et al:Contemporary Oral&Maxillofacial Surgery.4th ed.Mosby.Missorri.20032.W Booth,et al:Maxillofacial Surgery.Vol 1,2.1st ed.Churchill Livingstone.London.19993.邱蔚六主编邱蔚六主编.口腔颌面外科学口腔颌面外科学.第第5版版.人民卫生出版社人民卫生出版社.20042022-10-2355THE ENDTHE END2022-10-2356
