{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T20:07:55Z","timestamp":1770754075756,"version":"3.50.0"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T00:00:00Z","timestamp":1537747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Microvascular free tissue transfer is often employed to reconstruct significant facial defects from ballistic injuries. Herein, we present our comparison of complications between self\u2010inflicted and non\u2013self\u2010inflicted gunshot wounds after microvascular free tissue transfer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective case review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Approval was obtained from the JPS institutional review board. We performed a retrospective review of cases of ballistic facial injuries between October 1997 and September 2017 that underwent vascularized free tissue transfer for reconstruction. Comparisons were made between self\u2010inflicted and non\u2013self\u2010inflicted gunshot wounds after microvascular free tissue transfer. The \u03c7<jats:sup>2<\/jats:sup> test was used for all comparisons. <jats:italic>P<\/jats:italic> value and 95% confidence interval (CI) were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 73 patients requiring free flap reconstruction after gunshot wounds to the face during the study period. There was a statistically significant difference in the rates of nonunion between self\u2010inflicted and non\u2013self\u2010inflicted wounds (<jats:italic>P<\/jats:italic>\u2009=\u2009.02, 95% CI: 0.9 to 35.8) There were also no significant differences in flap failure (<jats:italic>P<\/jats:italic>\u2009=\u2009.10, 95% CI: \u22122.8 to 24.2), plate exposure (<jats:italic>P<\/jats:italic>\u2009=\u2009.28, 95% CI: \u22126.7 to 33.0), wound infection (<jats:italic>P<\/jats:italic>\u2009=\u2009.40, 95% CI: \u22128.9 to 31.2), scar contracture (<jats:italic>P<\/jats:italic>\u2009=\u2009.60, 95% CI: \u22128.1 to 25.1), and fistula formation (<jats:italic>P<\/jats:italic>\u2009=\u2009.13, 95% CI: \u22122.8 to 28.8) between patients with self\u2010inflicted and those with non\u2013self\u2010inflicted wounds. Overall, complication rates were significantly higher in the self\u2010inflicted group compared to the non\u2013self\u2010inflicted group (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001, 95% CI: 32.6 to 68.6).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with self\u2010inflicted injuries had more complications postoperatively than those with non\u2013self\u2010inflicted injuries. This is likely helpful in surgical planning and patient counseling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 129:837\u2013840, 2019<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27391","type":"journal-article","created":{"date-parts":[[2018,9,24]],"date-time":"2018-09-24T13:10:40Z","timestamp":1537794640000},"page":"837-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Higher Complication Rates in Self\u2010Inflicted Gunshot Wounds After Microvascular Free Tissue Transfer"],"prefix":"10.1002","volume":"129","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4294-8532","authenticated-orcid":false,"given":"Mofiyinfolu","family":"Sokoya","sequence":"first","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine Aurora Colorado U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurora G.","family":"Vincent","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Madigan Army Medical Center Tacoma Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery New York\u2013Presbyterian Hospital of Columbia and Cornell New York New York U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5811-3791","authenticated-orcid":false,"given":"Sameep","family":"Kadakia","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Colorado School of Medicine Aurora Colorado U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1814-0776","authenticated-orcid":false,"given":"Scott","family":"Kohlert","sequence":"additional","affiliation":[{"name":"Department of Facial Plastic and Reconstructive Surgery Otolaryngology and Facial Plastic Surgery Associates Fort Worth Texas U.S.A"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Ottawa Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Virginia Commonwealth University Richmond Virginia U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masoud","family":"Saman","sequence":"additional","affiliation":[{"name":"Saman Facial Plastics Plano Texas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yadranko","family":"Ducic","sequence":"additional","affiliation":[{"name":"Department of Facial Plastic and Reconstructive Surgery Otolaryngology and Facial Plastic Surgery Associates Fort Worth Texas U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2017.05.001"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199609001-00001"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199103000-00008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e3181e56e7e"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3281fbd3ef"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1293518"},{"key":"e_1_2_6_8_1","first-page":"218","article-title":"Early management, with a minimal initial hospitalization length, of major self\u2010inflicted rifle wounds to the face by a single latissimus dorsi free musculocutaneous flap: a 10\u2010year experience","volume":"9","author":"Danino AM","year":"2009","journal-title":"Open Access J Plast Surg"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.08.013"},{"key":"e_1_2_6_10_1","first-page":"586","article-title":"Plate related complication after mandibular reconstruction [in Chinese]","volume":"48","author":"Liu SP","year":"2013","journal-title":"Zhonghua Kou Qiang Yi Xue Za Zhi"}],"container-title":["The 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