BACKGROUND:Published reports describing management of complex facial lacerations in the emergency department are limited, and there is little guidance on the treatment of massive soft tissue avulsions of the head and face or severely contaminated head and face lacerations. Here, the authors report on the wealth of clinical experience they have gained in treating major head and facial injuries through an emergency trauma repair platform that was established in the department of orthopedic surgery at their hospital. METHODS:Six patients with massive soft tissue avulsions of the head and face caused by trauma were treated in our department between September 2017 and December 2018. Avulsion injuries occurred to the eyelids, ears, face, and part of the scalp. Defects extended from the skin to the surface of the bone. Emergency surgical repair involved reasonable debridement of the wound surface, accurate and meticulous suture, and use of local skin flaps. RESULTS:No patients experienced postoperative complications, such as necrosis, infection, or scar hyperplasia. Our postoperative satisfaction survey showed that 3 patients were very satisfied and 1 patient was relatively satisfied with their outcomes. Several patients (2/6) still had some degree of deformity in the soft tissue around the eyes, which required further surgery CONCLUSION:: Satisfactory functional and aesthetic outcomes can be achieved through reasonable debridement of the wound surface, accurate and meticulous suture, and use of local skin flaps in patients with massive soft tissue avulsions of the head and face caused by trauma.

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