Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
권호 표지
DOI QR코드

DOI QR Code

Management of maxillofacial injuries in bear mauling cases: a review of 20 cases

  • Kar, Indu Bhusan (Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital) ;
  • Chopda, Prashant Dilip (Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital) ;
  • Mishra, Niranjan (Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital) ;
  • Sethi, Alok Kumar (Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital) ;
  • Mahavoi, Bikas Ranjan (Department of Oral and Maxillofacial Surgery, Sriram Chandra Bhanja Dental College and Hospital)
  • Received : 2015.05.06
  • Accepted : 2015.06.26
  • Published : 2016.02.29
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: As the craniofacial and neck regions are prime areas of injury in bear attacks, the careful management of soft and hard tissue injuries and selection of reconstructive options is of the utmost importance. This study will review the incidence and patterns of bear mauling in eastern India reported to our department and the various modalities used for their treatment over a period of 7 years. It also documents the risks of infection in bear mauling cases and the complications that have occurred. Materials and Methods: Twenty cases were treated over the study period. Cases were evaluated for soft and hard tissue injuries including tissue loss and corresponding management in the craniofacial region. Cases were also evaluated for other associated injuries, organ damage and related complications. Results: Various modalities of treatment were used for the management of victims, ranging from simple primary repairs to free tissue transfers. Simple primary repairs were done in 75% of cases, while the management of the injured victims required reconstruction by local, regional or distant flaps in 25%. Free tissue transfers were performed in 15% of cases, and no cases of wound infection were detected in the course of treatment. Conclusion: Knowledge of various reconstructive techniques is essential for managing maxillofacial injuries in bear mauling cases. Modern reconstructive procedures like free tissue transfer are reliable options for reconstruction with minimal co-morbidity and dramatic improvement in treatment outcomes.

Keywords

References

  1. Udeabor SE, Akinbami BO, Yarhere KS, Obiechina AE. Maxillofacial fractures: etiology, pattern of presentation, and treatment in university of port harcourt teaching hospital, port harcourt, Nigeria. J Dent Surg 2014. doi: 10.1155/2014/850814.
  2. Devadiga A, Prasad KSV. Epidemiology of maxillofacial fractures and concomitant injuries in a craniofacial unit: a retrospective study. Int J Epidemiol [Internet]. 2007;5 [cited 2015 Jan 9]. Availby able from: http://print.ispub.com/api/0/ispub-article/6174.
  3. Nabi DG, Tak SR, Kangoo KA, Halwai MA. Increasing incidence of injuries and fatalities inflicted by wild animals in Kashmir. Injury 2009;40:87-9. https://doi.org/10.1016/j.injury.2008.06.042
  4. Iaizzo PA, Laske TG, Harlow HJ, McClay CB, Garshelis DL. Wound healing during hibernation by black bears (Ursus americanus) in the wild: elicitation of reduced scar formation. Integr Zool 2012;7:48-60. https://doi.org/10.1111/j.1749-4877.2011.00280.x
  5. Rasool A, Wani AH, Darzi MA, Zaroo MI, Iqbal S, Bashir SA, et al. Incidence and pattern of bear maul injuries in Kashmir. Injury 2010;41:116-9. https://doi.org/10.1016/j.injury.2009.07.077
  6. Park K. Park's textbook of preventive and social medicine. 22nd ed. Jabalpur: M/S Banarsidas Bhanot; 2011:254-5.
  7. Prasad SC, Thada ND, Rao P, Thada SR, Prasad KC. Grievous temporal and occipital injury caused by a bear attack. Case Rep Otolaryngol 2013. doi: 10.1155/2013/957251.
  8. Huang AH, Wong MS. Acute nasal reconstruction with forehead flap after dog bite. Ann Plast Surg 2013;70:401-5. https://doi.org/10.1097/SAP.0b013e31827ead6c
  9. Fell MJ, Ayalew Y, McClenaghan FC, McGurk M. Facial injuries following hyena attack in rural eastern Ethiopia. Int J Oral Maxillofac Surg 2014;43:1459-64. https://doi.org/10.1016/j.ijom.2014.07.006
  10. Hazani R, Buntic RF, Brooks D. Microsurgical scalp reconstruction after a mountain lion attack. Ann Plast Surg 2008;61:265-8. https://doi.org/10.1097/SAP.0b013e318160dff1
  11. Govila A, Rao GS, James JH. Primary reconstruction of a major loss of lower jaw by an animal bite using a "rib sandwich" pectoralis major island flap. Br J Plast Surg 1989;42:101-3. https://doi.org/10.1016/S0007-1226(89)90124-0
  12. Abrahamian FM, Goldstein EJ. Microbiology of animal bite wound infections. Clin Microbiol Rev 2011;24:231-46. https://doi.org/10.1128/CMR.00041-10
  13. Dhar SA, Butt MF, Farooq M, Mir MR, Wani ZA, Afzal S, et al. Pattern of orthopaedic injuries in bear attacks: report from a tertiary care centre in Kashmir. Injury 2008;39:249-55. https://doi.org/10.1016/j.injury.2007.07.028

Cited by

  1. Bear Maul Injury in Maxillofacial Region: A Case Report vol.1, pp.1, 2016, https://doi.org/10.1177/2632327319881071
  2. Study of Bear Bite Injury and Management in Tribal Belt of Chhattisgarh, India vol.7, pp.1, 2016, https://doi.org/10.18410/jebmh/2020/8