@article{ref1,
title="Higher complication rates in self-inflicted gunshot wounds after microvascular free tissue transfer",
journal="Laryngoscope",
year="2019",
author="Sokoya, Mofiyinfolu and Vincent, Aurora G. and Joshi, Rohan and Kadakia, Sameep and Kohlert, Scott and Lee, Thomas S. and Saman, Masoud and Ducic, Yadranko",
volume="129",
number="4",
pages="837-840",
abstract="OBJECTIVES/HYPOTHESIS: Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self-inflicted and non-self-inflicted gunshot wounds after microvascular free tissue transfer. STUDY DESIGN: Retrospective case review. <br><br>METHODS: Approval was obtained from the JPS institutional review board. We performed a retrospective review of cases of ballistic facial injuries between October 1997 and September 2017 that underwent vascularized free tissue transfer for reconstruction. Comparisons were made between self-inflicted and non-self-inflicted gunshot wounds after microvascular free tissue transfer. The χ<sup>2</sup> test was used for all comparisons. P value and 95% confidence interval (CI) were reported. <br><br>RESULTS: There were 73 patients requiring free flap reconstruction after gunshot wounds to the face during the study period. There was a statistically significant difference in the rates of nonunion between self-inflicted and non-self-inflicted wounds (P = .02, 95% CI: 0.9 to 35.8) There were also no significant differences in flap failure (P = .10, 95% CI: -2.8 to 24.2), plate exposure (P = .28, 95% CI: -6.7 to 33.0), wound infection (P = .40, 95% CI: -8.9 to 31.2), scar contracture (P = .60, 95% CI: -8.1 to 25.1), and fistula formation (P = .13, 95% CI: -2.8 to 28.8) between patients with self-inflicted and those with non-self-inflicted wounds. Overall, complication rates were significantly higher in the self-inflicted group compared to the non-self-inflicted group (P < .0001, 95% CI: 32.6 to 68.6). <br><br>CONCLUSIONS: Patients with self-inflicted injuries had more complications postoperatively than those with non-self-inflicted injuries. This is likely helpful in surgical planning and patient counseling. LEVEL OF EVIDENCE: 4 Laryngoscope, 2018.<br><br>© 2018 The American Laryngological, Rhinological and Otological Society, Inc.<p /> <p>Language: en</p>",
language="en",
issn="0023-852X",
doi="10.1002/lary.27391",
url="http://dx.doi.org/10.1002/lary.27391"
}