Management of gun shot injury in a tertiary hospital

Abstract

Introduction: Gun shot injury is an uncommon surgical emergency . A timely and multidisciplinary management by surgical team is an essential factor in decreasing mortality and morbidity . This study highlights the multidisciplinary management of gun shot injury.

Methodology: Bir hospital is a postgraduate teaching hospital under National Academy of Medical Sciences and tertiary referral center in Kathmandu. A prospective cohort study of gunshot injury was conducted during Septemeber 2015 and early outcome analysis was done.

Results: There were thirteen cases of gunshot wound. The mean age of casualty was 31 years and all were male.

Injury                 Number (n)    Intervention                             Outcome
Large intestine            3            Laparotomy                             Ileostomy/wound infection
Perineum                   1            Exploration/Debridement           Loop ileostomy
Bone- fracture            3            Traction/Enternal fixation/
                                               Open reduction Internal Fixation
Vertebra                     1                                                          Right hip power 3/5
Vascular- AV fistula      1           stenting                                   Referred
Brachial plexus            1                                                         Sensory/motor deficit
Neck                           2           Exploration                              Marginal mandibular
                                                                                             nerve palsy
Elbow                          1           Debridement/Split
                                               thickness skin graft

There were no mortality and one case was referred.

Discussion: With the multidisciplinary team approach, all the gunshot injury cases were managed with good outcome. The timely intervention by a surgical team is an essential factor for proper management of gun shot injury.