Penetrating Facial Injury by a Tree Branch: a Case Report

Abstract

Abstrak: Cedera tembus wajah dapat berbahaya karena adanya struktur-struktur penting pada wajah yang membutuhkan penanganan dengan cepat dan tepat. Benda asing organik dapat menyebabkan risiko tinggi infeksi luka. Kami memresentasikan suatu kasus yang jarang ditemukan yaitu seorang laki-laki berusia 19 tahun dengan luka tembus wajah oleh patahan cabang pohon akibat kecelakaan sepeda motor. Panjang cabang pohon 25 cm dengan diameter sekitar 4 cm, menembus melalui sisi depan kanan wajah, tepat di samping hidung, dan menjorok keluar melalui sudut kanan mandibula. Evaluasi dan penatalaksanaan cedera tembus wajah dilakukan mengikuti protokol ATLS. Tujuan penatalaksanaan cedera tembus wajah ialah mengeluarkan benda asing dengan trauma minimal pada struktur berdekatan dan mempertahankan fungsi dan penampilan yang normal. Pasien ini menjalani operasi darurat untuk pengangkatan benda asing dan eksplorasi luka dengan anestesi umum. Evaluasi pasca operasi tidak mendapatkan adanya perdarahan maupun tanda-tanda infeksi. Defisit neurologik pada wajah kanan diterapi secara konservatif dengan terapi fisik dan pulih sepenuhnya satu tahun pasca kecelakaan.
Kata kunci: luka tembus, trauma wajah, cabang pohon

Abstract: Penetrating facial injury can be dangerous because of the presence of important structures in the face which requires immediate and proper management. Organic foreign bodies may cause a high risk of wound infection. We present a case of a 19-year-old male with an unusual penetrating facial injury by a broken tree branch due to a motorcycle accident. The length of the tree branch was 25 cm with a diameter of approximately 4 cm, penetrating through the right anterior side of his face, just lateral to the nose, and protruding through the right angle of the mandible. The evaluation and management of the penetrating facial injury were performed in accordance with the ATLS protocol. The aim of the penetrating facial injuries management is to remove foreign body with minimal trauma to adjacent structures and to maintain the normal function and appearance. The patient underwent emergency surgery for removal of the foreign body and wound exploration under general anesthesia. In postoperative evaluation, there was not any bleeding or signs of infection. The neurological deficit in the right face was managed conservatively with physical therapy and was fully recovered in 1 year after the accident.
Keywords: penetrating wound, facial trauma, tree branch