A Comparative study of Debridement done at Emergency Complex and Operating Room as an Initial Management of Low Velocity Gunshot Wound

Abstract

Objectives:

To compare the results if debridement and delayed wound closure done at emergency is sufficient to the gold standard debridement procedure as an initial management in low velocity gunshot wound

Material and Method:

A retrospective study conducted at a tertiary center for which data were collected from the record section after the approval of the Chief of the medical record section. The demographic information of patients with low velocity gunshot wound were collected and reconfirmed from the department of orthopedics daily census sheet and follow-ups from outpatient department database. The Charts from 2007-2010 were reviewed and information were extracted.

Result:

The majority of the patients were from age group 20-39. The average mean age is 31.11. The male numbers were higher than female i.e. 94.44% and 5.56% respectively.  The femur was involved higher percentage than the tibia-fibula in the term of gunshot wound 58.33% and 41.67% respectively. The results showed no significant difference between terms of infection markers (White blood cell, C-reactive protein), hospital stay, fixation time with infection and infection rate. The infection rate seen was 7.32% and 6.45% respectively in the cases which were operated at Emergency complex and operating room. Comparing the two procedures in terms of cost, debridement done at emergency room has the advantage over procedure done at operating room since it’s cost effective.

Conclusion:

The procedure was comparable in terms of wound care management; infection rate; hospital stay and cost and also the result showed that local debridement and delayed wound care can be done as an initial management to treat the low velocity GSW.