Perioperative Management of Complex Mandibular Combat Trauma.

Abstract

As Ukraine (UA) responds to the increased demand for medical services due to combat injuries, the exchange of experiences and best practices between UA and American medical professionals can improve treatment and rehabilitation outcomes, promoting more efficient resource utilization and enhancing staff qualifications. The "Face to Face" initiative is a collaboration that brings American reconstructive surgeons and licensed nurses to Ukraine to work alongside local physicians. Multiple surgical techniques were used during the training collaboration. Medical records from 2022 to 2024 at a single center were retrospectively reviewed. All patients who underwent a free fibula flap technique procedure at a single institution in Lviv, Ukraine, were included if their medical records were complete. Age, length of stay, surgical techniques, and complications were summarized and compared. Six free fibula flap technique procedures were performed during the mission, and an additional 12 were completed independently. All patients were men, with a median age of 34.5 years (interquartile range, 29.5-45.0 years). The median surgical time for the procedure was 595 minutes. The median postoperative hospitalization was 25 days. No hematomas were reported, and only one case of persistent salivary drainage occurred. Acute wound complications were common (11/18; 61.1%), and they varied in severity. Five (27.8%) cases encountered infections at the wound site; one of the cases of infection led to a total flap loss. The outcomes of these cases are similar to results in the United States; however, the length of stay and acute wound complications were higher in the UA cohort. International collaboration is increasing the ability of UA to respond to the increased demand for complex mandibular surgeries. Sustained efforts between international collaboration will assist in cultural exchange and better outcomes for the UA people.