Surgical Management of Gunshot Wound at Level-II Hospital in Central African Republic in 2019/2020

Community Based Medical Journal Pub Date : 2022-01-10 DOI:10.3329/cbmj.v10i1.58649

M. Quader, Sheikh Shahidul Islam, Md Abdul Hamid, Md. Mahbubur Rahman, K. Islam

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Abstract

Background: Gunshot wounds (GSW) are common in Central African Republic (CAR). There are about eighteen rebel groups in Central Africa. Arms are available among the rebel groups and also the civilians. For the very simple region they open the fire against the opponent. The aim of this study is outcome of surgical management of gunshot wounds at Bangladeshi Level-II hospital in the CAR during our tenure. Methods: This was a prospective study of 14 patients with gunshot wounds who were treated at level-II hospital, Kagabandoro, CAR from Dec 2019 to Nov 2020 for a period of 12 months. Wound debridement and removal of bullets were done in 8 (57.14%) cases, keep bullets in situ position in 2(14.29%) cases and surgical toileting followed by primary closure of wound were done in 3 (21.42%) cases and one female patient transferred to level-III hospital in Bangui. Results: Out of 14 patients there were 13 male and 1 female patients. Mean age of the patients was 32.21 (18-55 years). High velocity injuries were common in 10 (71.43%). Injuries involved the limbs in 10 (71.43%), chest in 2 (14.29%), abdomen in 1 (7.14%) and external genitalia in 1(7.14%). Most of the patients 12 (85.71%) presented to the hospital within 12 hours of the injury. The average length of stay in the hospital was 14 days (Range 2- 60 days). Fractures of the long bone were in 5 (35.71%) cases. Open reduction and internal fixation was done in 3 (21.43%) cases. One female patient was transferred to level-III hospital in Bangui due to fracture neck of femur following gunshot injuries with 9 months of pregnancy. Mean follow-up was 5 months (Range 1-12 months). Post trauma pain developed in 3 (21.43%) cases, deformities of the extremities was found in 2 (14.29%) cases. Conclusion: Outcome of surgical management of the gunshot wounds were depends on the nature of tissue injury and availability of the resources with promptness of intervention. CBMJ 2021 January: vol. 10 no. 01 P: 04-08

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2019/2020年中非共和国二级医院枪伤的外科处理

背景:枪伤(GSW)在中非共和国(CAR)很常见。中非大约有18个反叛组织。反政府武装和平民都有武器。在非常简单的地区，他们向对手开火。本研究的目的是研究我们任职期间中非共和国孟加拉国二级医院枪伤手术治疗的结果。方法:这是一项前瞻性研究，研究对象是2019年12月至2020年11月在中非共和国卡加班多罗二级医院接受治疗的14例枪伤患者，为期12个月。伤口清创和取出子弹8例(57.14%)，原位保留子弹2例(14.29%)，手术如厕后初步缝合伤口3例(21.42%)，1名女性患者转至班吉三级医院。结果:14例患者中男性13例，女性1例。患者平均年龄32.21岁(18 ~ 55岁)。高速损伤10例(71.43%)。肢体损伤10例(71.43%)，胸部2例(14.29%)，腹部1例(7.14%)，外生殖器1例(7.14%)。多数患者(85.71%)在伤后12小时内就诊。平均住院时间为14天(范围2- 60天)。长骨骨折5例(35.71%)。切开复位内固定3例(21.43%)。一名怀孕9个月的女病人因枪伤后股骨颈骨折被转至班吉三级医院。平均随访5个月(范围1-12个月)。创伤后疼痛3例(21.43%)，四肢畸形2例(14.29%)。结论:枪伤的外科治疗效果取决于组织损伤的性质、资源的可得性和干预的及时性。中华医学杂志2021年1月第10卷第10期[01:04 -08

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Community Based Medical Journal

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