Epidemiology and Treatment of Complex Facial Wounds in Emergency Situations in an African Context: Experience at Brazzaville University Hospital

Facial wounds constitute a maxillofacial surgical emergency due to their functional and aesthetic impact and the vulnerability of prominent structures. Objective: To describe the epidemiological profile, timing of treatment and reconstructive techniques used at Brazzaville University Hospital. Materials and Methods: This is a descriptive cross-sectional study with retrospective data collection, conducted in the surgical emergency department and maxillofacial surgery department of Brazzaville University Hospital from January 2020 to December 2024 on patients treated for complex facial wounds. Results: A total of 58 patients with complex facial wounds were included in the study. The average age was 24 ± 2 years, with a predominance of males (sex ratio = 1.9). Road traffic accidents (56.9%) and assaults (29.3%) were the most common causes of injury. The injuries observed included: loss of substance (53.5%), lacerations (34.5%), other types of wounds (12%). Immediate reconstruction was performed in 89.6% of cases. In 60.3% of cases, treatment was delayed due to the availability of the operating theatre or waiting for medication. General anaesthesia was used in 42% of cases. The main procedures performed included: flaps: 30 cases, trimming and suturing: 16 cases. No microsurgery was performed. The postoperative outcomes were considered satisfactory in 82.2% of cases. Conclusion: Facial wounds mainly affect young men, most often as a result of road traffic accidents. Immediate reconstruction using local flaps is the most commonly used strategy, adapted to the resources available. Limited access to general anaesthesia remains a major constraint.