Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-06-02T22:19:02.630Z Has data issue: false hasContentIssue false
  • English
  • Français

Soft Tissue Infection after Missile Injuries to the Extremities–A Non-Randomized, Prospective Study in Gaza City

Published online by Cambridge University Press:  28 June 2012

Hazem M. Hamouda ,
Eivind Witsø ,
Nedal K.E. Moghani ,
Ahmed Shahwan  and
Øystein P. Nygaard
Hazem M. Hamouda
Affiliation:
Palestinian Red Crescent Society, Al Quds Hospital, Tel Al Hawa, Gaza City, Gaza Palestinian Authority
Eivind Witsø*
Affiliation:
St. Olavs University Hospital, Norweigan University of Science and Technology, Trondheim, Norway
Nedal K.E. Moghani
Affiliation:
Palestinian Red Crescent Society, Al Quds Hospital, Tel Al Hawa, Gaza City, Gaza Palestinian Authority
Ahmed Shahwan
Affiliation:
Palestinian Red Crescent Society, Balsam Hospital, Medical Services, Beit Lahia, Gaza Palestinian Authority
Øystein P. Nygaard
Affiliation:
St. Olavs University Hospital, Norweigan University of Science and Technology, Trondheim, Norway
*
Dr. Eivind Witsø Department of Orthopedic SurgerySt. Olavs University Hospital7006 TrondheimNorway E-mail: eivind.witso@stolav.no
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Patients with soft tissue injuries caused by missile attacks during wartime have been treated with radical debridement and delayed closure. In a study in Gaza City, the rate of infection of missile injuries to the extremities when treated with minimal surgical intervention, was measured.

Methods:

Patients with severe soft tissue damage, compound fractures, and injuries to major blood vessels and/or nerves were excluded from the study. One hundred fourteen patients were treated according to a standardized regime that included a superficial, minor surgery revision of the inlet and the outlet opening, and antibiotic treatment. Local soft tissue infection was defined as the presence of at least two signs of local infection.

Results:

A total of 109 out of 114 patients attended the first follow-up visit. Eleven (10%) of these patients had an infected wound. A total of 105 of the patients (92%) attended a second follow-up. None of these patients had an infected wound.

Conclusions:

Under conditions with a high number of causalities, minimal surgical treatment followed by the administration of antibiotics is a safe procedure for patients with penetrating missile injuries and less severe soft tissue damage.

Keywords

antibioticsextremity injuriesinfectionGaza Citymissile injuriessoft tissue infection
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 22 , Issue 2 , April 2007 , pp. 106 - 108
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Woloszyn, JT, Uitvlugt, GM, Castle, ME: Management of civilian gunshot fractures of the extremities. Clin Orthop 1988;226:247–251.CrossRefGoogle Scholar
2. Dickey, RL, Barnes, BC, Kearns, RJ, Tullos, HS: Efficacy of antibiotics in lowvelocity gunshot fractures. J Orthop Trauma 1989;3(1):6–10.CrossRefGoogle ScholarPubMed
3. Geissler, WB, Teasedall, RD, Tomasin, JD, Hughes, JL: Management of low velocity gunshot-induced fractures. J Orthop Trauma 1990;4(1):39–41.CrossRefGoogle ScholarPubMed
4. Knapp, TP, Patzakis, MJ, Lee, J, Seipel, PR, Abdollahi, K, Reisch, RB: Comparision of intravenous and oral antibiotic therapy in the treatment of fractures caused by low-velocity gunshots. A prospective, randomized study of infection rates. J Bone Joint Surg (Am) 1996;78(8):1167–1171.CrossRefGoogle Scholar
5. Bartlett, CS: Clinical update: Gunshot wound ballistics. Clin Orthop Relat Res 2003;408:28–57.CrossRefGoogle Scholar
6. Coupland, RM: Technical aspects of war wound excision. Br J Surg 1989;76(7):663–667.Google Scholar
7. Cooper, GJ, Ryan, JM: Interaction of penetrating missiles with tissue: Some common misapprehensions and implications for wound management. Br J Surg 1990;77:606–610.Google Scholar
8. Husum, H, Ang, SC, Fosse, E: War Surgery. Field Manual. Penang, Malaysia: Third World Network, 1995.Google Scholar
9. Molde, Å: Victims of war. Surgical principles must not be forgotten (again)! Acta Orthop Scand 1998;69(Suppl 281):54–57.Google Scholar
10. Coupland, RM: The Red Cross classification of war wounds: The E.X.C.F.V.M. scoring system. World J Surg 1992;16(5):910–917.Google Scholar
11. Bowyer, GW: Management of small fragment wounds: Experience from the Afghan border. J Trauma 1996;40(3):s170–s172.CrossRefGoogle ScholarPubMed