Our face is our identity, the first sign of remembrance that stays with us forever. Can you ever imagine losing your face? Vikram (Name Changed), a 33 year old boy, met with a road accident sustainingmultiple injuries and completely lost his face, where his own family couldn’t identify him. The accident was so severe that he sustained severe crush injurieson his face and upper neck after his four-wheeler collided into a stationary truck parked on the road side.
He was brought to Columbia Asia Hospital, Sarjapur Road by a bystander. “Upon initial evaluation in the emergency room, Vikram was found to have severe hemorrhagic shock and his blood pressure could not even be recorded,” said Dr. Bharath SP, Consultant Cosmetic and Plastic Surgeon, Columbia Asia Hospital, Sarjapur Road, Bengaluru.
Vikram's face revealed severe trauma with crush injury exposing multiple pieces of the facial bony fragments. The bones which hold the eyeball into the socket were all fractured because of which the eyeball had displaced down and out. Additionally, all of his wounds had been severely contaminated with road dirt and broken glass pieces.
There was a lot of blood in the throat which increased the risk of blood suddenly getting into the lungs. Especially with low consciousness, there were chances of him choking on it and die. Then the patient was immediately intubated in the emergency room and airway was secured. After fluid resuscitation, he was taken to the operation theatre immediately in order to stop all the bleeders and stabilize his condition.
It took 7 hours for all the bleedersto be stopped, the contamination to be removed so that no infection occurred. Before proceeding for a technical surgery to fix the facial fractures a temporary closure was done for Vikram to recover and stabilize.
After emergency surgery, he was put in the ICU for complete stabilization over the next 5 days with multiple blood transfusions and the ventilator support. It took 12 hours to fix all the facial bones and face, which was completely damaged.
Post-surgery, the patient was managed in ICU with tracheostomy care and the facial wounds/ intra-oral wounds care. Owing to multiple fractures in his mouth and jaw, he could not chew or even swallow so was managed with tube feedings. He was being evaluated by an ophthalmologist for his left eye vision.
Once stable, Vikram was shifted to a ward, tracheostomy was closed and he was able to take oral liquids with straw and syringe. “Post dental rehabilitation and with mouth exercising, he is much better now. His vision is also restored and good. We are just treating the scars now with scar massages, otherwise the patient is doing fine,” the doctor said.
“Columbia Asia Hospital Sarjapur Road came as a savior to me. Post-accident I never had a thought that I would get back to normal. I was in a very critical condition and my complete face was damaged, the moment I saw myself once I was back to consciousness, I was shattered, and had zero hopes of getting back my identity. But today I’m glad that I have got my face back, all thanks to all the doctors and the staff of the hospital” said Vikram.
Dr. Bharath also highlighted that while in such road traffic accidents, it is important for the driver to be careful and not over-speed, it is also very crucial for bystanders to take the responsibility and help the patient reach the nearest hospital on time as each second can make a difference in such severe scenarios.