War-related maxillofacial injuries in Ukraine: a retrospective multicenter study

BACKGROUND: The invasion of Ukraine by Russian troops on February 24, 2022, had significant humanitarian consequences. This conflict provides valuable data on the types and characteristics of war-related injuries, their epidemiology under modern warfare conditions, and the effectiveness of medical support and treatment strategies applied under challenging military circumstances with limited staff and resources. Therefore, this study aimed to analyze the prevalence and characteristics of war-related maxillofacial injuries during the Russian- Ukrainian war. METHODS: This retrospective multicenter study examined the demographic features, etiology, and characteristics of ballistic injuries among military personnel and civilians. Data were collected from the maxillofacial departments of six specialized military and civilian medical institutions in Kyiv and its surrounding regions. The study analyzed 415 patients with gunshot and blast injuries admitted to these hospitals from February 24, 2022, to February 24, 2024. For each patient, parameters such as age, sex, social status, trauma-associated complications, concomitant injuries to other organs and systems, New Injury Severity Scores, and Facial Injury Severity Scale scores were recorded. RESULTS: Among the 415 patients, 96.9% were male. Isolated maxillofacial injuries were observed in 75 patients (18%), while ophthalmic injuries were present in 208 patients (50.1%). Primary care for the majority of patients was provided in military hospitals near the front line or in primary, secondary and tertiary regional medical institutions. Wound debridement and closure were performed as primary interventions in 358 patients (86.3%), and more than half of the patients received primary maxillofacial care within 24 hours of injury. CONCLUSION: The primary cause of war-related maxillofacial injuries was high-energy blast trauma resulting from artillery strikes, mines, drones, rocket attacks, and bombings. War-related military trauma involved soft tissue damage in 97.1% of cases.