{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:59:07Z","timestamp":1787169547456,"version":"build-2736575974"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Rationale:<\/jats:title>\n                    <jats:p>Bear mauling is the most common wild animal-inflicted injury in India. Ideally, these injuries should be managed early with fracture fixation, wound debridement, and appropriate coverage. Delay may lead to devascularization and a more severe deformity, which needs complex and multi-staged procedures for optimal outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Concerns:<\/jats:title>\n                    <jats:p>Facial deformity in bear mauling is upsetting to the patient. Apart from facial aesthetics, the victim has difficulties in speech, eating, and respiration when the midface is involved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis and Treatment:<\/jats:title>\n                    <jats:p>Patients require proper assessment of the soft tissue and bony defects by clinical assessment and imaging before planning any reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome:<\/jats:title>\n                    <jats:p>The complex defect was managed in stages by both microsurgical and nonmicrosurgical methods including debridement, fracture fixation, local flaps, free flap, and prosthesis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Take-away Lessons:<\/jats:title>\n                    <jats:p>Systematic approach in categorizing each component of the problem, finding the best possible solution for each of them, and inter-departmental collaboration are important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ams.ams_218_21","type":"journal-article","created":{"date-parts":[[2022,2,1]],"date-time":"2022-02-01T08:34:28Z","timestamp":1643704468000},"page":"359-362","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Management of a Late Presentation of Bear Mauling with a Complex Maxillofacial Defect in a Tertiary Care Hospital - A Case Report"],"prefix":"10.4103","volume":"11","author":[{"given":"Jiten Kumar","family":"Mishra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moumita","family":"De","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamendra Anand","family":"Sahu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ripu Daman","family":"Arora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manish J","family":"Raghani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitin M.","family":"Nagarkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-32-20240828","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.cjtee.2017.11.001","article-title":"A review of upper limb injuries in bear maul victims: Consistent pattern and inverse relation in severity with facial and scalp injuries","volume":"21","author":"Bhat","year":"2018","journal-title":"Chin J Traumatol"},{"key":"R2-32-20240828","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/2632327319881071","article-title":"Bear maul injury in maxillofacial region: A case report","volume":"1","author":"Vasishta","year":"2019","journal-title":"Traumaxilla"},{"key":"R3-32-20240828","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1007\/s12663-011-0328-4","article-title":"Bear maul injuries in maxillofacial region: Our experience","volume":"11","author":"Geetha","year":"2012","journal-title":"J Maxillofac Oral Surg"},{"key":"R4-32-20240828","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.injury.2009.07.077","article-title":"Incidence and pattern of bear maul injuries in Kashmir","volume":"41","author":"Rasool","year":"2010","journal-title":"Injury"},{"key":"R5-32-20240828","doi-asserted-by":"crossref","first-page":"13","DOI":"10.5125\/jkaoms.2016.42.1.13","article-title":"Management of maxillofacial injuries in bear mauling cases: A review of 20 cases","volume":"42","author":"Kar","year":"2016","journal-title":"J Korean Assoc Oral Maxillofac Surg"},{"key":"R6-32-20240828","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s12663-010-0126-4","article-title":"Maxillofacial Injuries due to Bear Mauling","volume":"10","author":"Ram","year":"2011","journal-title":"J Maxillofac Oral Surg"},{"key":"R7-32-20240828","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1055\/s-0037-1603459","article-title":"Prosthetics in facial reconstruction","volume":"11","author":"Klimczak","year":"2018","journal-title":"Craniomaxillofac Trauma Reconstr"},{"key":"R8-32-20240828","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1067\/mpr.2001.119524","article-title":"Prosthodontic guidelines for surgical reconstruction of the maxilla: A classification system of defects","volume":"86","author":"Okay","year":"2001","journal-title":"J Prosthet Dent"},{"key":"R9-32-20240828","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/SCS.0000000000004976","article-title":"The paramedian forehead flap for nasal reconstruction: From antiquity to present","volume":"30","author":"Shokri","year":"2019","journal-title":"J Craniofac Surg"},{"key":"R10-32-20240828","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1097\/00006534-200205000-00010","article-title":"A 10-year experience in nasal reconstruction with the three-stage forehead flap","volume":"109","author":"Menick","year":"2002","journal-title":"Plast Reconstr Surg"}],"container-title":["Annals of Maxillofacial Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ams.ams_218_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:08:42Z","timestamp":1787166522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ams.ams_218_21"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":10,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/ams.ams_218_21","relation":{},"ISSN":["2231-0746"],"issn-type":[{"value":"2231-0746","type":"print"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}