Craniofacial Impalement Injury: A Case Report

Abstract

Background: Technological advancement and industrialization are often occasioned by increased incidence of industrial accidents, some of which are life-threatening. This is especially so when the craniofacial complex is the primary site of involvement owing to the presence of vital structures. This report aims to highlight important aspects of the management of craniofacial impalement injuries.  

Case presentation: A 26-year-old male artisan who operates a locally fabricated blade sharpening machine presented at our hospital, with an impalement injury to the craniofacial complex. A discoid sharpening blade with an abrasive exterior measuring about 10x15x2.5 cm was firmly lodged in his craniofacial region. Surgical intervention was centered on multispecialty collaboration, thorough neurological assessment, adequate imaging, careful manipulation and handling during intubation, early antibiotic therapy, hemorrhage control using external carotid artery ligation, early removal of impaled object in a controlled environment, adequate wound debridement and primary closure. Temporary ligation of the ipsilateral external and carotid artery was deemed to have allowed unbalanced exploration, and safe removal of the fibriacotomy body given the high risk of torrential bleeding.  

Conclusion: Industrial accidents are emerging public health concerns in our clinics. Oral maxillofacial surgeons need to be abreast with the principles of their initiation. The need for prevention of these events by the necessary protective precautions by the regulating agencies is paramount. Despite introduction of preventive methods, such events may still occur, thus it is important to have the necessary skills, support, and equipment to manage it successfully.