Penetrating, perforating, and avulsive fragmentation injuries present a unique surgical challenge for oral and maxillofacial surgeons in the Iraqi theater of operation. Maxillofacial injuries encountered in Operation Iraqi Freedom I and Operation Iraqi Freedom II have presented injury patterns not encountered previously in other large-scale armed conflicts. Current literature in the field of oral and maxillofacial surgery does not cover adequately the concerns that are inherent to care and treatment planning at an echelon III facility. This article addresses clinical and surgical practice guidelines that were developed by oral surgeons in theater and from feedback they received from higher echelons of care.
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