The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan 2003-2011

Abstract

Objective Define the number and type of facial and penetrating neck trauma injuries sustained in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). Study Design Retrospective database study. Setting Tertiary care level I trauma center. Subjects and Methods The Joint Theater Trauma Registry (JTTR) was queried for data from OIF and OEF from January 2003 to May 2011. Information on demographics; type and severity of facial, neck, and associated trauma injures; and impact on overall mortality was recorded. Results There were 37,523 discrete facial and penetrating neck injuries that occurred in 7177 service members. There were 25,834 soft tissue injuries and 11,689 facial fractures. The most common soft injury sites were the face/cheek (48%), neck/larynx/trachea (17%), and mouth/lip (12%). The maxilla (25%), mandible (21%), and orbit (19%) were the most common facial fracture sites. The most common mechanism of injury was penetrating (49.1%), followed by blunt (25.7%), blast (24.2%), and other/unknown/burn (1%). Injuries were associated with an overall mortality rate of 3.5%. The highest risks for mortality were treatment at a level IIa facility, female sex, prehospital intubation, and blast injury. Most injuries were mild to moderate. Conclusion Facial and penetrating neck trauma are common in modern warfare. Most injuries are minor to moderate and survivable. Training and potential body armor updates can be made. Medical personnel deploying to support OIF and OEF could benefit from specific training in the management of facial and penetrating neck injuries. A surgeon skilled in managing these injuries would likely be beneficial in a deployed setting.