Can Seatbelts Save Your Face?
MADISON—Safety experts have known for years that seatbelts and airbags can prevent deaths in automobile accidents.
Plastic surgeons now have evidence that they can also help prevent serious facial trauma.
A research group at University of Wisconsin School of Medicine and Public Health studied extensive accident data from the National Trauma Database from 2000-2004, poring over the results of more than 15,000 facial-fracture patients and more than 114,000 cases of facial laceration (jagged cuts). The study appears in the current issue of the Plastic and Reconstructive Surgery Journal.
The surgeons found that crash victims who failed to use both an airbag and seatbelt were more than twice as likely to experience serious facial laceration and trauma and nearly three times as likely to suffer a "panfacial" injury, a more serious type of injury often accompanied by multiple fractures and neurological damage. Panfacial injuries are also more difficult for plastic surgeons to treat and repair.
"In the past decade, we've seen a decline in the number of facial fractures from people involved in car accidents," says Dr. Karol Gutowski, a UW School of Medicine and Public Health professor of surgery. "What's happened since then? Safety features like seatbelts and airbags have become standard on most new automobiles. This study seems to suggest that when people use seatbelts and airbags deploy, people have fewer facial injuries."
The problem, as the patient data reveals, is that drivers and passengers aren't always using them. The UW group's research also shows that nearly 60 percent of the crash victims studied used no safety devices at all. Another fascinating finding: Victims who skipped the seatbelt and relied only on an airbag received little to no protection from facial trauma.
"It could be that the airbags are protecting people from bodily injuries, but creating more facial fractures," says Dr. D. Heath Stacey, an assitant professor of surgery at UW School of Medicine and Public Health. "Clearly, when an airbag deploys, you get more impact to your face."
From a surgical recovery perspective, the difference between a minor and a panfacial fracture can be stark.
"If you have one or two fractures, you can build from the known to the unknown on a patient's face, and it's easy to match," says Dr. Stacey. "When you have a patient with a smashed face, the outcomes are often less favorable."
According to Dr. Stacey, a patient who suffers a panfacial injury spends an average of seven days in the hospital.
Dr. Gutowski and Dr. Stacey believe that the study is strong evidence that plastic surgeons - and more important, primary care physicians, who see patients before they experience a facial injury - across the country should join state and national efforts advocating for seatbelt and airbag use from a public health perspective.
Gutowski and Stacey perform plastic surgery at UW Health Transformations; co-author John Doyle is a UW Health dentist and a professor of surgery at UW School of Medicine and Public Health.
Date Published: 06/26/2008