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Management of Self-Harm Injuries in the Maxillofacial Region: A Report of 2 Cases and Review of the Literature

Malaga, EG; Aguilera, EMM; Eaton, C; Ameerally, P; (2016) Management of Self-Harm Injuries in the Maxillofacial Region: A Report of 2 Cases and Review of the Literature. Journal of Oral and Maxillofacial Surgery , 74 (6) 1198.e1-1198.e9. 10.1016/j.joms.2016.02.018. Green open access

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Abstract

Clinicians face numerous challenges when managing psychiatric patients who self-inflict injuries within the maxillofacial region. In addition to a complex clinical examination, there are both surgical and psychiatric factors to consider, such as the risk of damaging vital structures, the exacerbation of the patient's psychiatric status, and the long-term psychosocial and esthetic sequelae. We present 2 cases of adolescents who repeatedly self-inflicted wounds and/or inserted foreign bodies (FBs) into the face, scalp, and neck. The different treatment modalities were based on full evaluation of the patient's clinical, medical, and diagnostic test findings coupled with a psychiatric assessment. The decision for conservative management or surgical intervention was made according to the presence and location of the FBs, degree of hemorrhage, signs and symptoms of infection, and unpleasant scars that could lead to long-term psychological impairment. In most cases, the FBs were removed and the wounds were toileted and closed under local or general anesthesia. We advocate a holistic approach via a multidisciplinary team, which is deemed essential to provide the highest quality of care for patients to reduce the risk of further relapses. Lastly, a satisfactory esthetic outcome is always paramount to achieve long-term psychological and physical welfare.

Type: Article
Title: Management of Self-Harm Injuries in the Maxillofacial Region: A Report of 2 Cases and Review of the Literature
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.joms.2016.02.018
Publisher version: https://doi.org/10.1016/j.joms.2016.02.018
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Restorative Dental Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10087847
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