Open-packing method for the severely comminuted fractured mandible due to missile injury

A new approach is introduced to treat a severely comminuted fractured mandible due to missile injury, whereby denuded bony pieces are re-incorporated into the defect. These are then immobilized by open-packing with iodoform ribbon gauze. The pack is changed regularly every 10–14 days until the cavity is completely obliterated with healthy granulation tissue by which time the mandible shows good consolidation with re-alignment of all displaced bony fragments. The method is simple, safe, does not need an expert surgeon and avoids the need for a future bone graft. Iodoform packs were used in different sites of the facial skeleton and none of our patients showed signs of sensitivity to iodoform or to iodine toxicity.