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- W2884996429 abstract "Both military and civilian surgeons can encounter ballistic wounds in their practice; these injuries can be complex and challenging. Tissues exert a drag force on the round as it passes through, absorbing Kinetic Energy as tissues are damaged. Tissue damage occurs via three mechanisms: creation of a permanent cavity, temporary cavitation and finally the generation of a shock wave which has negligible clinical relevance. Assessment of the ballistic wound prior to surgery is necessary to plan the surgical strategy. Surgeons should look for features of high-energy transfer: large wounds, round fragmentation, bone strike, partial or fully retained rounds. Muscle tissue typically tolerates the stretching effect of temporary cavitation well. After resuscitative life saving surgery, the priorities of orthoplastic reconstructive surgery are: incision, excision, fixation and coverage. Skin incisions are longitudinal along limbs; fascial incisions permits local decompression but consideration should always be given to full fasciotomy and compartment decompression. Ballistic wounds evolve over many hours after injury; tissue can progress to necrosis over time, swell and produce copious exudate. Outside of the head and neck, wounds should never be closed primarily, and patients should be returned to the operating theatre at around 48 hours for re-assessment and further tissue excision if necessary. Fractures should be temporarily stabilised, normally with an external fixator to protect the wound bed. Definitive fixation should only occur at the same surgical episode as definitive coverage or closure." @default.
- W2884996429 created "2018-08-03" @default.
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- W2884996429 date "2018-01-01" @default.
- W2884996429 modified "2023-09-26" @default.
- W2884996429 title "Ballistic Trauma-Considerations for the OrthoPlastic Surgical Team" @default.
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- W2884996429 doi "https://doi.org/10.29337/ijops.16" @default.
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