War Surgery of the Face and Head *

The therapeutic objectives in wounds of the face are restoration of function and reduction of disfigurement. The treatment of war injuries of the face may be divided into three types: 1) primary complete repair, 2) temporary treatment, 3) reconstruction. Primary complete treatment is indicated for fresh wounds where tissue loss is minimal. Temporary treatment should be used for infected or badly contaminated wounds of some duration and for those in which tissue loss is considerable. Reconstruction, in these cases, should be undertaken at a later date, under more favorable conditions. This work is a highly technical form of maxillo-facial surgery and will not be discussed at this time. However, it is important to realize that the problems of reconstruction may be magnified many fold by improper early treatment. The results of bone infection, the unsightly scars of widely placed, tight coarse sutures left in position too long, may prove insurmountable obstacles to satisfactory reconstruction. Certain characteristics of the facial tissues are quite favorable to their surgical repair. Important among these are the excellent blood supply and the relatively high resistance to infection. Gas gangrene of the face is practically unknown. For discussion purposes, it is convenient to classify facial injuries on the basis of the tissue involved (Table 1).