Journal of Trauma and Injury

Case Report

Facial trauma and reconstructive surgery: insights from a case series of severe maxillofacial injuries: Harendra Kumar, Abdul Hakeem, Abdul Vakil Khan, Rachith Sridhar, Deepak Kumar, Majid Anwer; J Trauma Inj. 2026;39(1):94-103. Published online February 4, 2026; DOI: https://doi.org/10.20408/jti.2025.0080

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Abstract PDF: Facial trauma is a complex and important contributor to trauma-related morbidity, often requiring multidisciplinary management due to intricate anatomy and the dual need for functional and aesthetic restoration. This case series describes a spectrum of maxillofacial injuries treated by trauma surgeons, including soft tissue degloving, zygomaticomaxillary complex fractures, mandibular fractures, and airway compromise. All patients were managed in accordance with Advanced Trauma Life Support (ATLS) principles. Surgical interventions included layered wound closure, open reduction and internal fixation, and airway management through endotracheal intubation, cricothyroidotomy, or tracheostomy. The series underscores the critical decision-making required in airway management, the surgical expertise necessary for fracture stabilization, and the importance of early reconstruction in optimizing outcomes. It further emphasizes the role of trauma surgeons in delivering comprehensive care and highlights the value of preventive strategies such as helmet use and road safety enforcement. These cases contribute to the growing evidence that timely, coordinated surgical intervention supports optimal recovery in patients with facial trauma.; Summary

Original Article

Vascularized tissue coverage of trauma and acute care surgery defects with ovine forestomach matrix: interim results of a prospective multicenter study: Michael T. Cormican, W. Matthew Vassy, Carolyn Cook, Christopher A. Butts, John Loftus, Jessica Simon, D. Adam Young, Alison A. Smith; J Trauma Inj. 2026;39(1):42-51. Published online January 20, 2026; DOI: https://doi.org/10.20408/jti.2025.0090

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5 Citations

Purpose
Traumatic soft tissue defects present challenges due to their diverse presentations. This variability necessitates tailored approaches for effective management, requiring advanced reconstruction strategies to achieve rapid coverage and tissue infill while minimizing complications. The study aimed to evaluate the safety of ovine forestomach matrix (OFM) grafts in traumatic defects from four level I trauma centers.
Methods
This prospective observational study used a multicenter registry to collect deidentified data from adult trauma/acute care surgery patients who received OFM-based grafts for soft tissue repair from August 2022 through September 2024. After the application of OFM grafts, defects were regularly assessed for the development of vascularized tissue coverage and/or fill, and ultimately epithelialization.
Results
During the study, 49 participants with 61 soft tissue defects underwent procedures with OFM-based grafts. The mean participant age was 58.8±17.7 years. Most defects (55.7%) resulted from traumatic injuries, with additional etiologies including necrotizing soft tissue infections (13.1%), enterocutaneous fistulas (4.9%), acute pressure injuries (stages III and IV, 6.6%), surgical dehiscence (4.9%), amputations (3.3%), and hematoma evacuation (3.3%). All defects achieved vascularized tissue coverage within a median of 22.5 days (interquartile range, 13.3–33.5 days) after a median of one product application (interquartile range, 1–1). Four cases of superficial infection were reported, all resolving without major complications.
Conclusions
OFM-based grafts showed promising results in tissue regeneration for trauma and acute care defects, with minimal postoperative complications. These results are interim findings from an ongoing prospective multicenter registry study evaluating the safety and efficacy of OFM-based grafts in various surgical applications.

Summary

Citations

Citations to this article as recorded by

Reconstruction of Deep Partial-Thickness Burns With Ovine Forestomach Matrix: Results From a Prospective Observational Study
Patrick J Kennedy, Michael Young, Kylie Wentworth, Nidhi Aravapalli, Nicole P Bernal, Ariel Rodgers, Laura Pezzopane, Beth McGuire, Jessica Simon, D. Adam Young, John Loftus
Cureus.2026;[Epub] CrossRef
Ovine forestomach matrix for wound treatment: an integrative review
Marcos Fortes, João Moreira, Ana Carolina Fernandes, Débora Wilbert
European Journal of Plastic Surgery.2026;[Epub] CrossRef
Surgical management of stage 3 and 4 pressure injuries in trauma patients using ovine forestomach matrix grafts: a prospective case series
Sophia M. Trinh, Kaitlyn Andre, Ada I. Özcan, Dhanushka S. Vitharana, Paige E. Deville, Joseph W. Mason, John P. Hunt, Alan B. Marr, Patrick P. Greiffenstein, Lance E. Stuke, Alison A. Smith
Frontiers in Surgery.2026;[Epub] CrossRef
Multi‐Centre, Single‐Arm, Prospective Evaluation of Ovine Forestomach Matrix for the Treatment of Complex Wounds in the South Asian Population
Salesh K. Soni, Ritesh Panda, Mohan G. Kakola, Jasleen Kaur, Brandon A. Bosque, Barnaby C. H. May
International Wound Journal.2026;[Epub] CrossRef
Safety of Ovine Forestomach Matrix Across 474 Soft Tissue Defects: Interim Results from the Prospective Multicenter MASTRR Registry
Tracee Short, John Lawlor, Patrick Martyka, Joshua H. Wolf, Jessica M. Felton, Alison A. Smith, Yosef Y. Nasseri, Moshe Barnajian, W. Matthew Vassy, Michael Cormican, Pranat Kumar, John J. Choi, Lung Lau, John H. Loftus, Nicole P. Bernal, Christopher A. B
Advances in Therapy.2026;[Epub] CrossRef

Case Report

Catastrophic complications from inadequate early soft tissue surveillance in a closed pilon fracture: a case report: Jeong-Hyun Koh, Sumin Lim, Hyung Keun Song, Wan-Sun Choi, Won-Tae Cho, Seungyeob Sakong; J Trauma Inj. 2025;38(4):404-411. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0158

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Abstract PDF: We present the case of a 55-year-old man with an AO/OTA 43-C3 pilon fracture in whom initial uniplanar external fixation failed to relieve persistent medial skin tenting, resulting in focal ischemic necrosis. Within 72 hours, the patient developed bullae and violaceous discoloration, which progressed to full-thickness skin breakdown. Despite staged open reduction and internal fixation and fasciocutaneous flap coverage, the patient developed chronic osteomyelitis, ultimately requiring segmental bone resection to control the infection. The patient underwent serial debridement procedures and placement of antibiotic-loaded cement spacers. Definitive reconstruction was achieved with salvage tibiotalocalcaneal arthrodesis using the Expert Tibial Nail system on postoperative day 319. Twelve months after fusion and bone grafting, radiographs confirmed solid union, and the patient was ambulating independently, albeit with considerable long-term functional limitations. This case underscores the importance of early and meticulous soft tissue evaluation in high-energy pilon fractures. Prompt repositioning of fracture fragments or the use of adjunctive decompression is essential. Delayed or inadequate decompression can lead to a cascade of complications, beginning with soft tissue necrosis and progressing to deep infection and limb salvage fusion, even when standard fixation protocols are followed.; Summary

Original Article

S-100B in Extracranial Fracture Patients Without Head Trauma: Tae Woong Park, Dong Hoon Lee, Sang Jin Lee, Sung Eun Kim, Chang Woong Kim; J Korean Soc Traumatol. 2009;22(2):123-127.

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Abstract PDF: PURPOSE
There is an increasing amount of evidence that S100B could function as a marker of brain damage. However, the cerebral specificity of S100B has been questioned, so the extracerebral sources of S100B have been paid attention. We performed this investigation to show serum S100B levels after extracranial fracture in patients without current head injury and without prior neurological disease.
METHODS
At the emergency department, we obtained the blood samples within 6 hours from trauma patients hospitalized with extracranial fractures. S100B levels were compared between one fracture and more than two fractures, and analyzed according to the presence of soft tissue damage.
RESULTS
Patients with one fracture and those with more than two fractures did not differ by age (mean, 54.70 vs. 47.03, p=0.130), and there was no significant difference in the male-to-female ratio(33:32 vs. 21:12, p=0.226). In patients with one fracture, the mean value of S-100B was 0.56 microgram/L (95% CI: 0.35-0.77) whereas in those with more than two fractures, the corresponding value was 1.09 microgram/L (95% CI: 0.46-1.7, p=0.048). The S100B level of patients with soft tissue damage(1.32+/-0.38) was higher than that of patients without soft tissue damage(0.81+/-0.21), whether one fracture or more than two fractures(p=0.049).
CONCLUSION
We present here that S100B levels were raised in 77% of patients with extracranial fractures without cerebral injury who were hospitalized from the emergency room and that the presence of soft tissue damage contributed to the increased S100B rather than the size of the fractured bone size or the number of fracturest. Thus, this study suggests that soft tissue injury may be considered as an important extracerebral source of S100B.; Summary

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