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[Removal of the wadding from the wound in shotgun-pellet injuries]
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Inönü University, 44065 Malatya, Turkey. iesenkaya@hotmail.com
Objectives:
Most of the gunshot injuries are caused by low-velocity bullets and shotgun pellets, resulting in mild soft tissue damage. They are sometimes associated with vascular involvement and fractures depending on the angle of entry. Bullets and especially pellets usually lodge in soft tissues. For those that are not easily detected, surgical exploration is not recommended unless they are of vital localizations. However, the removal of wadding, which may incite a local inflammatory response and harbor bacterial contaminants, is strongly recommended.
Methods:
Of forty-one patients with shotgun injuries, eight patients were found to bear waddings that required removal.
Results:
Waddings made of cork and plastic were removed from one and seven patients, respectively. In addition to patients' histories and wound-related features, radiolucent plastic waddings were predicted by the presence of a cluster of pellets on radiographs. Fractures were encountered in the injured extremity in six patients. No infections developed related to the primary wound.
Conclusion:
Although it is often difficult to locate a lodged wadding in the body, its removal is necessary because it can incite a local inflammatory response and harbor bacterial contaminants.