• J Orthop Trauma · Jun 2017

    Infection Rates and Treatment of Low-Velocity Extremity Gunshot Injuries.

    • Mai P Nguyen, Jonathan C Savakus, Jeffrey A OʼDonnell, Nicholas F Prayson, Michael S Reich, Joseph F Golob, Amy A McDonald, John J Como, and Heather A Vallier.
    • MetroHealth System, Case Western Reserve University, Cleveland, OH.
    • J Orthop Trauma. 2017 Jun 1; 31 (6): 326-329.

    ObjectivesTo determine the rates of infection in low-energy gunshot wounds (GSWs) to the extremity.DesignRetrospective review.SettingLevel I trauma center.Patients/ParticipantsPatients (N = 140) with at least 90-day follow-up for extremity-only low-energy GSW injuries from 2010-2014 were retrospectively reviewed. Treatment was recorded, including type and duration of antibiotics and details of nonoperative and operative managements.Main Outcome MeasuresThe rates of superficial and deep infections.ResultsThe overall infection rate was 15.7% (22 patients), and the deep infection rate was 3.6% (5 patients). Age, sex, and injury location were similar between the groups that did and did not receive antibiotic prophylaxis. Injury Severity Scores were higher in the group that did receive antibiotics. Regarding soft tissue-only injuries, antibiotic prophylaxis trended toward a lower rate of overall infection versus no antibiotic prophylaxis (6.1% vs. 25.9%, respectively, P = 0.07). Multiple doses of antibiotics did not reduce the rate of infection when compared with a single dose (14.6% vs. 12.5%, respectively, P = 1.00). No deep infections occurred in patients with nonoperatively treated fractures, regardless of antibiotic administration. All operatively treated fractures received antibiotic prophylaxis and demonstrated superficial and deep infection rates of 15.1% and 5.7%, respectively.ConclusionsInfections after low-energy extremity GSWs are infrequent. For soft tissue injuries without fracture, a single dose of intravenous antibiotics in the emergency department was associated with a lower rate of infection compared with no antibiotics. Operatively treated low-energy GSW fractures should receive standard perioperative antibiotics.Level Of EvidencePrognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

      Pubmed     Full text   Copy Citation  

      Add institutional full text...

    Notes

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.