Pathomorphological and quantitative bacteriological findings in various forms of primary surgery on gunshot wounds of extremities

• Published in: Archives of orthopaedic and trauma surgery 2001-11, Vol.121 (10), p.566-570
• Main Authors: ZHANG, Ya-Dong, HOU, Shu-Xun, ZHANG, Wei-Jia, SHENG, Zhi-Yong
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Debridement; Dogs; Drainage; Leg Injuries - microbiology; Leg Injuries - pathology; Leg Injuries - surgery; Medical sciences; Miscellaneous; Random Allocation; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Therapeutic Irrigation; Wounds, Gunshot - microbiology; Wounds, Gunshot - pathology; Wounds, Gunshot - surgery
• ISSN: 0936-8051; 1434-3916
• DOI: 10.1007/s004020100268

It is well-known that 'wound excision' is essential in the primary treatment of wounds in war, particularly thorough debridement of the devitalized tissues around the path of a penetrating projectile. Nowadays, the gunshot wounds in peacetime have become prevalent. Instead of the traditional method of 'wound excision' (excision), we used the method of 'incision and drainage' (incision) in the primary surgery of these gunshot wounds of extremities. To determine the treatment effectiveness of these different surgical methods (incision and excision), two groups of dogs were shot in the proximal part of one hind leg with an American M-16 rifle. One group was treated by the method of 'excision'; in the other group 'incision' were performed. No difference in infection rate was noted between the two groups. Similarly, no difference in bacterial count was found between the two groups during the observation period. Also, there was no difference in healing time; the wounds in both groups had healed by 19.2-21.4 days. Microscopic examination revealed a little normal muscle tissue in the necrotic zone of the incision group which might augment the repair process. These results suggest that there are no differences in the effectiveness in preventing infection between the two methods. 'Incision' might be superior to 'excision' for the management of the gunshot wounds of extremities in peacetime, as it involves a simple operation and there are advantages for tissue healing.