Abstract

Improvised explosive device (IED) injuries that develop from near-distance and affect the vital organs may cause significant morbid results in maxillofacial, truncal and thoracoabdominal regions. In this article, we present a 21-year-old male patient admitted to our hospital due to IED injury of maxillary region. Tissue defect of 3¥2 cm that affected the superficial and deep tissues and massive hemorrhage from within the defect were observed in right maxillary region. Right internal maxillary and sphenopalatine arteries were clamped and massive hemorrhage was stopped. However, since the leaking hemorrhage did not stop in the patient with currently stable hemodynamics, hemostatic buffering material was packed into maxillary and pterygopalatine regions to perform immediate treatment considering a possibility of internal carotid artery laceration and to provide adequate compression and the right buccal flap was left open with open abdominal buffering technique. After the hemostatic buffering material and external buffers were removed during the reconstructive and second-look surgery that was performed three days later, leakage or active hemorrhage was not seen under the buccal flap that was left open. We may conclude that this buffering administration, which is performed in abdominal surgeries, may also be used in maxillofacial surgeries for massive hemorrhage control in case of sufficient area and proper indication.