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The principles of medical nutrition of maxillofacial wounded are based on knowledge of metabolic disorders, the periods and phases of wound process. The mechanical trauma causes organism response which consists in a metabolic disorder - proteinaceous, carbohydrate, vitamin, mineral and others. In the general exchange (metabolic) reaction of an organism to a trauma distinguish two phases: the first - katabolic, a phase of the strengthened expenditure of fabric resources. It occurs 7-10 days and changes the second phase - anabolic, a phase, restoration of all types of an exchange.

Violation of a proteinaceous exchange are shown by considerable reduction of the general protein of blood - a hypoproteinemia, strengthening nitrogen allocation with urine-azoturia that testifies to disintegration of protein and negative nitrogenous balance. Patients thus, as a rule, lose weight. Critical falling of weight is observed for 3-4 days after a trauma. Loss of weight of a body at patients happens with injuries of a face and jaws as well at the expense of partial malnutrition which is caused by specifics of a trauma. Consequence of proteinaceous insufficiency which results from a trauma, violation of work of fermental systems. The general hypoproteinemia sharply reduces immunobiological forces of an organism that threatens with emergence of bronchopulmonal and other infectious complications.

Violation of energetic exchange at trauma, the first minutes, is defined by an exit in glucose blood from a liver and muscles. In blood is raised content of sugar - a hyperglycemia and its increased allocation decides on urine - a glucosuria.

At a trauma is carried out higher level of a metabolism, in comparison with norm in which active participation take vitamins - ascorbic acid, tiamin, Riboflavinum, a pyridoxine and niacid. The general develops hypovitaminosis.

Violations of a water-salt exchange at the expense of the increased loss of water by an organism are observed at dehydration. In the first days at a considerable trauma the organism can lose to 2000-3000 ml of water, including in exhaled air - 150-300 ml, at the expense of sweating - to 500 ml, with urine - 1000-1500 ml, with excrement - to 200 ml, and patients with a trauma of bodies have oral cavities - also at the expense of considerable salivation. At dehydration viscosity of blood increases, the volume of circulating blood in vessels and blood-groove speed decreases. Such condition can promote oxygen starvation of tissues and violation of function of cages. At a trauma there is a violation of cellular zymogenic processes that leads to potassium transition from cages on extracellular environment therefore its content in serum of blood raises.

Acid-base balance is the most severe constant of the internal environment. This ratio of concentration of ions of hydrogen (H +) to hydroxyl ions (OH-) in biological environments. In norm рН of blood and histic liquids makes 7,35-7,45. рН less than 6,8 and more than 7,8 incompatible with life. Constancy рН in an organism is provided with existence of four so-called "buffer systems": bicarbonate, phosphatic, hemoglobinic and proteinaceous. The last - the most considerable. The bicarbonate system consists of carbonic acid (H2CO3) and bicarbonates which are out of cages (NaHCO3) and in cages (KHCO3). Bicarbonates prevent shift рН in the sour party. If there is a shift in the sour party, speak about acidosis. Opposite on a condition is alkalosis when in an organism surplus a meadow, that is shift рН in the alkaline party is formed.

A food of patients with injuries of a face and jaws is one of considerable problems in the general complex of treatment and measures for leaving.

The maxillofacial trauma complicates a nibble of food and its chewing. Complications at meal and helplessness of the patient grow in process of weight of a trauma, at violation of integrity of bones of a facial skeleton, especially mandible, or damages of tongue, a hard or soft palate, a throat, a mouth floor. It is very important to remember that all this depressing affects first of all the patient because forms at him idea of full physical weakness. Violation of mentality is promoted also by an injury of a brain which is accompanied by consciousness loss. Damages of the large vessels feeding a brain at wound of the face and jaws can be also one of the reasons of unstable mentality. To features of a maxillofacial trauma belongs as well that after rendering the specialized help which consists most often from an immobilization of jaws by means of dental tires and intramaxillary fixation or draft, meal through a mouth becomes complicated.

Patients with a maxillofacial trauma need before each feeding special preparation, and after food – special care.

Types of diets for patients with injurys of face and jaws. The most widespread in a stomatologic hospital of diets are: maxillary №1, maxillary №2 and the general.

The diet maxillary №1, or probe is appointed to patients at whom owing to a considerable trauma all components of the acceptance report of food are broken that usually happens at a trauma which is accompanied by damage of tongue, the palatine, a mouth floor with the expressed hypostasis of tissues. In this case food introductions in a mouth not only it is inexpedient, but also it is dangerous because its aspiration is possible. The cooked food (diet No. 15) is passed through a meat grinder and a dense sieve, filtered to exclude existence of substances which are difficult crushed (vegetable cellulose, meat streaks, etc.).

The diet maxillary №2 is appointed to patients who have normal function of swallowing and sucking. The food at this type of a diet is necessary to pappi condition.

Thus, the purpose of maxillary diets is providing the patient with a full-fledged enteroalimentation when as a result of a trauma the chewing act is violated, but peroral meal is possible by means of a poilnik or a spoon (a diet maxillary №2) or when all components of the act of feeding are broken, including swallowing, a food through a mouth is replaced broach (a diet maxillary the first or probe). Transfer from a maxillary diet on a table d'hote in the post-traumatic period is carried out on the basis of clinical data.

The general diet d'hote (No. 15) is appointed to patient who doesn't need a special food. It is physiologically full-fledged diet with use of all range of products which meet standards of hospital. So, all products and dishes with use of usual, various culinary processing are resolved.