Surgical treatment of heavy forms of bullet and splinter wounds of maxillofacial area, regenerative
surgeries.
War wounds
During war the merit of chair of oral and maxillofacial surgery was huge. At the height of war, in 1992 1993, wounded was so much, that in branch of chair there were no places to station them. A part of the
therapeutic branch located on 4th floor was given at our disposal. The branch served only the wounded
soldiers, there was no civil patients at all. Branch chambers have been overcrowded by wounded from
explosion of mines, crystal and hail rockets, those who received fragmental and bullet wounds with
difficult fractures of extremities, jaw, face etc. Those days in the end of a corridor of branch and in a
reception hall the stretchers that were used to deliver wounded from Zabrat airport, were stacked to a
ceiling. We became witnesses of terrible scenes that we saw on the TV earlier. We have appeared face to
face with atrocities of the enemy. We worked by very intensive schedule. Bandagings, rendering of the
qualified medical aid occupied the most time. Wounded men get to our branch from Fizuli and Terter
hospitals. Right on the spot they were rendered the first medical aid, the field doctors stopped the
bleeding, and then the injured were sent to us. All personnel, from the professor to the sanitary worker,
served wounded men tirelessly. Sometimes family knew nothing about their wounded and we became
their kin persons. Wounds were too complicated. Can you imagine that because of a smell of a gangrene
of a bone, and a stench anaerobic infection we could hardly enter the wards. The smell extended on all
branch. Usual weapons could not cause such infections. Probably in enemy weapons, bullets, rockets
there were carriers of infection. There were the patients whose wounds did not heal for months. During
the period when we treated fragmental and bullet wounds, other illnesses occurred. Kidneys, liver, a
stomach joined the process. It seemed, that soldiers, remaining in cold entrenchments for months,
congealed the illnesses in themselves.
Bullet-proof vests and helmets protected a head and body above a belt from bullets, etc., but faces
remained exposed to any bombardment. Many arrived unrecognizable because of heavy forms of bullet
and fragmental wounds of jaws, nose, eye hollow, and forehead area. Having entered into a body, bullets
formed a small hole, and at exit destroyed the big area of an organism. There were such injured, looking
on which, we used to cover in horror. Relatives could not identify them even. For example, there was a
patient by the name of Mustafa, a machine gun bullet has punched an middle part of his face: both parts
of an antrum of highmore, jaws, teeth, eye hollows. We conducted 8 regenerative surgeries.
Many wounded were treated stage by stage. There were such wounded who postponed surgery for the
future time. Many after recovery beared a complex because of cicatricial traces and defects on face. They
still consult us, wishing to get cosmetic transformations. On the face of the wounded man by the name of
Shirzad, the cicatricial tissues remained not looking at the performed repeated regenerative surgeries. I
will notice, that we have restored the punched part of a jaw by a plastic surgery. All over the world there
are standard rules concerning and osteoplastic surgeries, and surgeries of soft tissues - these surgeries
should be done stage by stage.
And now we willingly assist the participants of military actions who have addressed to us.
Aspiration to cure wounded men as soon as possible, compelled employees of chair including me, to
search for new ways of way out. Working over ourselves, we began to find new successful methods. For
example, the device invented by me provides reposition, i.e. returning of a bone to the former place and
strengthening in the necessary position in various areas of the face, especially in the top jaw and in a
zygomatic bone. In terrible days of war, we by means of this device eliminated traumas and deformations
of the face. For example, one wounded experienced wrong bite because of sunken top jaw. In spite of the
fact that we have set up a bimaxilarius splint, after its removal we found out, that the jaw remained on a
former place. The invented device intended for reposition, fixation of a zygomatic bone. However, we
have applied it to return jaw forward to its original place.
Advantage of this device, that it released many patients from open surgery. After surgery a cicatricial
fabric remains on skin. It is rather difficult to reach antrum of Highmore through a mouth and to lift a
zygomatic arch. This is where superiority of the given device is obvious. Journalist Vagif Isagogly has
published an article «Əlac özümüzə qalıb» - «hope only on ourselves» in «Khalq Ordusu» newspaper.
He described this and other device invented by us during military years. By means of this device we have
returned many patients to a normal life. Besides our branch has eliminated all defects which appeared in
jaws from blows, bullets and splinters by the way of plastic surgeries. For example, for elimination of
defect of a jaw of 10 cm we have used our own tactics and have achieved good results. In the days of war
there were no titanium plates and screws. Now we restore fractures by modern ways. Back then we used
tissues of the patient because of absence of modern implants and details. Taking into consideration
presence of an additional fragment in huckle-bone we used to cut out a necessary piece and made
transplantation. We also used to take transplant material from 12th rib, to restore a jaw and return the
wounded man to a normal life.
World medicine has proved, that own tissue gives the better effect, than taken from a corpse, or
preserved. By means of own transplant we restored tissues and bones. These surgeries in other countries
demand enormous monetary expenses. We carried out restoration by the simple way applied in
traumatology - made fixing with the titan - tantan wires. Autografts, applied at restoration of bone
fractures, defects and soft tissues, remain in organism for life.
Now these patients have the chewing, speech and swallowing functions completely restored. Certainly,
there were such difficult defects restoration of which has appeared impossible. For example, one of
wounded men had both eyes injured, and became blind. The eyeballs have been completely destroyed, the
optic nerve has been torn off. I wish to notice, that during treatment of wounded men ophthalmologists
closely co-operated with us. We in common performed the surgeries and necessary manipulations. The
enemy party used eccentric bullets. We could hardly find a place of penetration of a bullet, but on exit it
completely destroyed soft tissues. At such wounds we used to start regenerative treatment after primary
recover. A method of Filatov’s stick a skin and hypodermic fatty tissues stage by stage were replaced
from stomach area, from a forward wall of a stomach, from a lateral wall of a hip.
We were amazed with eagerness to fight and courage of our soldiers. They aspired on to recover faster
and return to fighting numbers. Patriotism at them was so strong, that they hurried up to leave, as soon as
wounds started to heal. We tried to return the favor.
Now we meet heavy gunshot wounds very seldom. Experience of military years helps us to cope with
such cases quickly.
Recently a patient with heavy wounds of jaws from fire-arm has arrived in our branch. Employees of
chair had conducted a surgery and a jaw was restored by means of titanium plates. After recovery the
patient visited Germany for consultation. The German experts were pleasantly surprised by high level of
the surgery performed by us. Operation was approved, though they did not believe it was carried out in
Azerbaijan. Collected experience and knowledge can be an example on a global scale. We have articles
and dissertations in this sphere. I would like to state that my dissertation is dedicates to military wounds. I
have protected the master's thesis on a subject «Influence free sulphurous amino acids on process of
regeneration of a bone tissue at fractures of jaws». A part of this dissertation part is dedicated to a
problem of regeneration of bones after a bullet wound. Other scientific works in this direction are also
developed in our Chair.
Whether it be military or a peace time we cannot inform the world of the facts of enemy evil deeds. On
international scene our country still lags behind in the field of an information transfer. There should be
more literary feature, documentary films, articles, books and other means reflecting atrocities of the
enemy for granting to the world community. The facts of use by the enemy of the forbidden methods and
means are well-known to doctors. Activity of the doctors standing face to face with horrors of war, has
not interested information resources of the republic. Pictures of the heavy wounded men in our hospital,
were not printed anywhere. In days of war the condition of hospitals, rendering assistance to the wounded
man has been described in a local press very seldom. My speech does not go about activity of some
doctor in particular. No I just say that it is better to ask doctors about the implementation by the Armenian
party of forbidden weapons, about bullets with chemically harmful structure and their complications, and
also about atrocities to which prisoners of war and civilians were exposed. The information collected by
doctors could have been used with a point of view of propagation and propagation means.