What happens when a 17-year-old girl arrives at the trauma center with her face destroyed by a shotgun blast? In this episode, we explore an extraordinary case that demonstrates why specialized expertise and immediate intervention make all the difference between life and death.

The shotgun injury created catastrophic damage, essentially removing the girl's face from the eyebrows down to the nose. Most trauma centers would have classified this as non-survivable. But Dr. Long assembled a team with unique qualifications—Dr. Bryce Potter, an oral-maxillofacial surgeon, and Dr. Mark Buehler, a microsurgery specialist—who approached this challenge with revolutionary thinking.

Instead of following the conventional staged approach to reconstruction, the team performed complete repair during the initial admission. Their philosophy? "A patient is never healthier than when they first present to the ER." By establishing an airway through tracheostomy, multiple specialists worked concurrently rather than sequentially, drastically reducing time to definitive care.

The cornerstone of the reconstruction was a "free flap"—living tissue transferred from the patient's leg that included fibula bone, soleus muscle, and skin. This complex microsurgery required connecting tiny blood vessels to maintain circulation to the transplanted tissue. When unexpected complications arose with blood flow during the procedure, the team's adaptability proved crucial.

The outcome was remarkable. Despite catastrophic facial trauma, the patient regained the ability to eat and speak. She went on to live a functional life for twenty years before additional cosmetic procedures, even having two children during that time.

Listen now to understand the extraordinary measures that transform seemingly hopeless situations into stories of survival and recovery. Because when the need is greatest, saving time truly saves lives.

To learn more about these life saving strategies and techniques, look for Dr. Long’s upcoming book, Flatline to Lifeline.

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Producer: Esther McDonald

Technical Director: Lindsey Kealey, of PAWsitive Choices

Editing and Post Production: Adam Scott of Atamu Media Productions

© Flatline to Lifeline 2025