Victoroff B N, Robertson W W, Eichelberger M R, Wright C
Department of Orthopaedic Surgery, Children's National Medical Center, Washington, DC 20010.
Pediatr Emerg Care. 1994 Feb;10(1):1-5. doi: 10.1097/00006565-199402000-00002.
In the years 1985 to 1989 75 children and adolescents presented to an urban children's hospital for treatment of 76 incidents of extremity gunshot wounds. Although the population ranged widely, the "typical" patient was a preteen or teenager (n = 70) who was shot in the lower extremity (n = 53) with a low velocity handgun (n = 74). No vascular injuries and only two transient nerve injuries accompanied the wounds. Only 30% of the shots caused fractures. Many (43%) of the patients had other relevant psychosocial or medical problems. Previous treatment for other gunshot wounds or trauma had occurred in 27 patients. Although follow-up was not good, no consequent infections were identified. Outpatient local wound irrigation with minimal debridement sufficed as treatment for entry/exit wounds without contamination or fracture. Intravenous antibiotics are necessary in these wounds only for short-term prophylactic coverage of fractures. Larger soft tissue wounds, intraarticular foreign bodies, and fracture stabilization require operative treatment.
1985年至1989年间，75名儿童和青少年前往一家城市儿童医院，接受76例四肢枪伤的治疗。尽管患者群体差异很大，但“典型”患者是一名儿童或青少年（n = 70），下肢被低速手枪射中（n = 53）（n = 74）。伤口伴有无血管损伤，仅有两例短暂性神经损伤。只有30%的枪伤导致骨折。许多患者（43%）有其他相关的心理社会或医学问题。27例患者曾接受过其他枪伤或创伤的治疗。尽管随访情况不佳，但未发现继发感染。对于无污染或骨折的进出伤口，门诊局部伤口冲洗加最小限度清创足以作为治疗方法。这些伤口仅在骨折的短期预防性覆盖时需要静脉使用抗生素。较大的软组织伤口、关节内异物和骨折固定需要手术治疗。
