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World Journal of Surgery
Published in: World Journal of Surgery 8/2016

01-08-2016 | Original Scientific Report

Analysis of Risk Factors for Gunshot Wound Infection in a Nigerian Civilian Trauma Setting

Author: Njoku Isaac Omoke

Published in: World Journal of Surgery | Issue 8/2016

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Abstract

Background

Survivors of firearm injury are at risk of wound infection. On average, civilian gunshot wound infection rates in developing countries are relatively high and almost on a par with infection rates in war trauma settings. Overall, there are limited data on civilian gunshot wound infection and its predisposing factors. The aim of this study was to determine the risk factors for gunshot wound infection in a civilian trauma setting of a developing nation.

Materials and method

This was a retrospective analysis of data on the entire patients who presented in Federal Teaching Hospital Abakaliki with firearm injury from January 2005 to December 2014.

Results

There were 196 patients, and wound infection was a complication in 58 (29.6 %) of them. The significant factors for high wound infection rate in univariate analysis were perforating wound (p < 0.001), high velocity injury (p < 0.001), haematocrit <30 % (p < 0.001), presence of fracture (p < 0.001), hollow viscus injury (p < 0.001) and injury to hospital arrival interval later than 6 h (p < 0.014). Anatomical site of injury correlated with infection rate (p < 0.001), highest rate (40.6 %) in lower extremity and least (9.1 %) in head and neck wounds. Multivariate logistic regression analysis identified haematocrit (p < 0.001), perforating wound (p < 0.021), presence of fracture (p < 0.043) and hollow viscus injury (p < 0.039) as independent predictors of gunshot wound infection.

Conclusion

The independent predictors of infection identified in this study call for judicious replacement of blood loss and high priority accorded to perforating wound, fractures and hollow viscus injury in interventions aimed at reducing gunshot wound infection rate.
Literature
1.
Sing RF, Branas CC, Mackenzie EJ, Schwab CW (1997) Geographic variation in serious non-fatal firearm injuries in Pennsylvania. J Trauma 43(5):825–830CrossRefPubMed
2.
3.
Murray CK (2008) Infectious disease complications of combat- related injuries. Crit Care Med 36(7):S358–S364CrossRefPubMed
4.
5.
Kucisee-Tepes N, Bejuk D, Kosuta D (2006) Characteristics of war wound infection. Acta Croat 60:353–363
6.
Petersen K, Hayes DK, Blice JP, Hale RG (2008) Prevention and management of infection associated with combat related head and neck injury. J Trauma 64:S265–S276CrossRefPubMed
7.
Simechen E, Sacks T (1973) Infection in war wound: experience during the 1973 October war in Israel. Ann Surg 182(6):754–761CrossRef
8.
Petersen K, Riddle MS, Danko JR, Hayden R, Tasker SA, Dunne JR (2007) Trauma—related infections in battlefield casualties from Iraq. Ann Surg 245(5):803–811CrossRefPubMedPubMedCentral
9.
Aarabi B (1987) Comparative study of bacteriological contamination between primary and secondary exploration of missile head wound. Neurosurgery 20(4):610–616CrossRefPubMed
10.
Mody RM, Zapor M, Hartzell JD et al (2009) Infectious complications of damage control orthopaedics in war trauma. J Trauma 67(4):758–761CrossRefPubMed
11.
Woloszyn JT, Ultvlugt GM, Castle ME (1988) Management of civilian Gunshot fractures of the extremities. Clin Orthop 226:247–251PubMed
12.
Gary JO, Geron FS, Jonathan SW et al (1993) Infections in minor gunshot wounds. J Trauma 34(3):358–365CrossRef
13.
Weigelt JA, Haley RW, Seibert B (1987) Factors which influence the risk of wound infection in trauma patients. J Trauma 27(7):774–779CrossRefPubMed
14.
Persad IJ, Reddy RS, Saunders MA et al (2005) Gunshot injuries to the extremities: experience of a UK trauma centre. Injury 36:407–411CrossRefPubMed
15.
Onuminya JE, Ohwowhigagbese E (2005) Patterns of civilian gunshot injuries in Irrua, Nigeria. S Afr J Surg 43(4):170–172PubMed
16.
Chalya PL, Mchembe M, Mabula JB et al (2011) Gunshot injuries: a Tanzania experience in a Teaching Hospital in the Lake zone. East Central Africa J Surg 16(1):19–25
17.
Adesanya AA, Afolabi IR, Da Rocha-Afodu JI (1998) Civillian abdominal gunshot wound in Lagos. J R Coll Surg Edinb 43:230–234PubMed
18.
Chamsia I (2008) Civilian abdominal gunshot wound in Durban South Africa: a prospective study of 78 cases. Ann R coll Engl 90:581–586CrossRef
19.
Olasinde AA, Ogunlusi JD, Ikem IC (2012) Outcome of treatment of gunshot fractures of lower extremities with interlocking nails. S Afr Orthop J 11(4):48–51
20.
Hopf HW, Hunt TK, West JM et al (1997) Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg 132:997–1005CrossRefPubMed
21.
22.
Tien H, Nascimento B, Callum J et al (2007) An approach to transfusion and haemorrhage in trauma: current perspective on restrictive transfusion strategies. Can J Surg 50(3):202–209PubMedPubMedCentral
23.
Di Maio VJM (1999) An introduction to the classification of gunshot wounds. In: Gunshot wound practical aspects of firearm, ballistics and forensic technique, 2nd edn. CRC Press, New York, p 82
24.
Bartflett CS, Helfet DL, Hausman MR et al (2000) Ballistics and gunshot wound effect on musculoskeletal tissues. J Am Acad Orthop Surg 8:21–36CrossRef
25.
26.
Shah MM, Ali U, Zaman FU et al (2008) Morbidity & mortality of firearm injury in Peshawar region. J Ayub Med coll Abbottabad 20:102–104PubMed
27.
Davis M, Kevin M, Glickman E (2011) Inner-city Gunshot wound - 10 years. Injury 42:488–499CrossRef
28.
Ofiaeli RD (1997) Gunshot wound in a semi urban Nigeria population: a review of 50 cases. Trop J Med Res 49–53
29.
30.
Namdari S, Baldwin K, Matuszewski P et al (2012) Delay in surgical debridement of open tibia fracture: an analysis of national practice. J Orthop Trauma 25(3):140–144CrossRef
31.
Omoke NI, Chukwu COO, Madubueze CC et al (2012) Outcome of road traffic injury received in the emergency room of a teaching hospital South east Nigeria. Trop Doct 42:18–22CrossRefPubMed
32.
Norouzpour A, Khoshdel AR, Modaghegh M et al (2013) Prehospital management of gunshot patients at major trauma care centre: exploring the gaps in patient care. Trauma Mon 18(2):62–66CrossRefPubMedPubMedCentral
33.
Mould-Millman N, Sasser SM, Wallis LA (2013) Prehospital research in Sub -Saharan Africa: establishing research tenet. Acad Emerg Med 20(12):1304–1309CrossRefPubMed
34.
Kalaiselvan G, Dangre AR, Mahalakshmy T (2011) Epidemiology of injury in rural Pondicherry. India J Inj Violence Res 3(2):62–67PubMed
Metadata
Title
Analysis of Risk Factors for Gunshot Wound Infection in a Nigerian Civilian Trauma Setting
Author
Njoku Isaac Omoke
Publication date
01-08-2016
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 8/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-016-3475-4

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