Facial injuries from bear attacks: A retrospective analysis highlighting periorbital trauma and the need for tissue defect management.
- 1Department of Plastic and Reconstructive Surgery, Iwate Medical University, 1-1-1 Idaidori, Yahaba-cho, Shiwa-gun, Iwate Prefecture, 028-3694, Japan.
- 2Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
Abstract
Objective
Bear attacks often cause severe facial trauma requiring complex surgical management. We aim to analyze facial injuries caused by Ursus thibetanus and discuss optimal treatment.Methods
We conducted a single-center retrospective study of patients with facial trauma caused by bear attacks who were treated at Iwate Medical University Hospital (2017-2022). We analyzed demographic information, injury details (skin, soft tissue, bone involvement), treatment approaches, number of surgeries, and complications. Associations between Facial Injury Severity Scale (FISS) scores, tissue defects, infection, and length of hospital stay (LOS) were evaluated using Spearman's rank correlation coefficient, Mann-Whitney U test, and multivariable regression analysis. p< 0.05 was considered statistically significant.Results
A total of 26 patients (22 men, 4 women; median age, 70.5 years [interquartile range (IQR), 66.3-76.5]) sustained facial skin injuries; the eyelid was the most affected site (20 patients). Soft tissue defects were observed in 9 patients and facial fractures in 16 patients. Critical structures (globe, lacrimal canaliculus, parotid duct, facial nerve) were damaged in 14 patients, with 5 globe ruptures. The median FISS was 2.00 [IQR, 1.00-3.00]. Infection occurred in 9 patients. Overall median LOS was 15.0 days [IQR, 9.25- 28.8]. Patients with tissue loss had significantly longer LOS (median, 30.0 days [IQR, 28.0-48.0] vs. 11.0 days [IQR, 8.0-15.0]; p < 0.001). Neither infection nor FISS significantly affected LOS (p = 0.152 and p = 0.820, respectively).Conclusions
Bear attacks frequently cause severe facial injuries, often affecting the eyes. Tissue loss significantly prolongs LOS.
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BibTeX
@article{wakai2026facial,
title = {{Facial injuries from bear attacks: A retrospective analysis highlighting periorbital trauma and the need for tissue defect management.}},
author = {H Wakai and A Onodera and I Sone and S Azuma and T Honda and M Sakuraba},
journal = {JPRAS open},
year = {2026},
month = sep,
doi = {10.1016/j.jpra.2026.09.029},
url = {https://europepmc.org/article/MED/42904167},
note = {CC BY},
}
RIS
TY - JOUR
TI - Facial injuries from bear attacks: A retrospective analysis highlighting periorbital trauma and the need for tissue defect management.
AU - H Wakai
AU - A Onodera
AU - I Sone
AU - S Azuma
AU - T Honda
AU - M Sakuraba
PY - 2026
DA - 2026/09/30
JO - JPRAS open
DO - 10.1016/j.jpra.2026.09.029
UR - https://europepmc.org/article/MED/42904167
AB - Objective Bear attacks often cause severe facial trauma requiring complex surgical management. We aim to analyze facial injuries caused by Ursus thibetanus and discuss optimal treatment.Methods We conducted a single-center retrospective study of patients with facial trauma caused by bear attacks who were treated at Iwate Medical University Hospital (2017-2022). We analyzed demographic information, injury details (skin, soft tissue, bone involvement), treatment approaches, number of surgeries, and complications. Associations between Facial Injury Severity Scale (FISS) scores, tissue defects, infection, and length of hospital stay (LOS) were evaluated using Spearman's rank correlation coefficient, Mann-Whitney U test, and multivariable regression analysis. p< 0.05 was considered statistically significant.Results A total of 26 patients (22 men, 4 women; median age, 70.5 years [interquartile range (IQR), 66.3-76.5]) sustained facial skin injuries; the eyelid was the most affected site (20 patients). Soft tissue defects were observed in 9 patients and facial fractures in 16 patients. Critical structures (globe, lacrimal canaliculus, parotid duct, facial nerve) were damaged in 14 patients, with 5 globe ruptures. The median FISS was 2.00 [IQR, 1.00-3.00]. Infection occurred in 9 patients. Overall median LOS was 15.0 days [IQR, 9.25- 28.8]. Patients with tissue loss had significantly longer LOS (median, 30.0 days [IQR, 28.0-48.0] vs. 11.0 days [IQR, 8.0-15.0]; p < 0.001). Neither infection nor FISS significantly affected LOS (p = 0.152 and p = 0.820, respectively).Conclusions Bear attacks frequently cause severe facial injuries, often affecting the eyes. Tissue loss significantly prolongs LOS.
SN - 2352-5878
ER -