What are the key indications for referring a patient to maxillofacial surgery for facial trauma?

Key indications for referring a patient to maxillofacial surgery for facial trauma include the presence of complex facial fractures, such as open or depressed fractures of the facial bones, significant displacement of bone fragments, and involvement of critical anatomical structures like the orbit, mandible, or maxilla. Referral is also warranted when there is evidence of airway compromise related to facial injury, persistent bleeding that cannot be controlled by initial measures, or suspected involvement of the dentoalveolar structures requiring specialist intervention. Additionally, patients with associated head injuries meeting criteria for CT imaging or those with neurological deficits should be considered for specialist assessment to coordinate care. Referral should be prompt in cases of high-energy trauma, multiple facial fractures, or when there is suspicion of non-accidental injury or complex soft tissue damage requiring surgical repair. Early involvement of maxillofacial surgeons ensures appropriate management of both functional and aesthetic outcomes, including airway management, haemostasis, and restoration of facial structure and occlusion (Kvaal and Kvaal, 2000; NICE NG39, NICE NG232, NICE NG40).