Approach for Initial Treatment of Combined Trauma Patients. Treatment Protocol in Maxillofacial Trauma Patients Admitted at Department of Maxillofacial Surgery

Background Correct therapeutic approach and algorithm of behaviour for diagnostics and treatment of combined traumas requires a high level of interdisciplinary cooperation and coordination. This leads to optimizing the therapeutic and diagnostic process and improves prognosis and outcome of patients treatment. Purpose To determine an approach for initial treatment of combined trauma patients and to present a treatment protocol in maxillofacial trauma (MFT) patients admitted at the maxillofacial surgery (MFS) wards Material and methods A total of 352 traumatic patients were retrospectively and prospectively examined for the period 05.2005 - 12.2011, treated at the MFS Ward at the St. Anna University Multidiscipline Active Treatment Hospital in Sofia, whereas MFT were determined in 129 patients. Results The largest number of patients have been treated between the 3rd and 5th post trauma days - 38 (29.5 %), equal number of patients between the 5th and 10th days - 33 (25.6 %) and up to the third day - 33 (25.6 %), after the 10th day - 25 patients (19.4 %).49, 6 % were treated ander general anaesthesia, 43, 4 %- under local anaesthesia and 7 % under atar analgesia or sedation and local anaesthesia. Our study results indicate that regarding neurosurgical traumas, MFT are significantly rarely treated after the 10th day (x2, =0=021) ConclusionMaxillofacial surgeon has the extremely important and responsible role in diagnostics, planning and performing of therapy of MFT patients. Early inclusion of MFS is important in multiple trauma patients and is essential for exact and correct diagnosis, as well as for adequate MFT treatment.