Primary treatment of shotgun injuries to the face.

The treatment of close-range shotgun wounds to the face can be extremely difficult. Over the years, surgeons have progressed from the conservative approach of debridement and delayed reconstruction to that of immediate reconstruction. While the complex nature of these injuries requires treatment on an individual basis, the principles of conservative debridement, thorough wound cleansing, and primary replacement of soft-tissue defects will often result in a better functional and esthetic restoration in a shorter period of time. Five patients with shotgun facial wounds managed by individualized primary repair are discussed.