Management of mole gun injuries: Review of 19 cases with proposed treatment algorithm

Injuries caused by mole guns are mostly localized in the hands and characterized by contaminated and necrotic tissues due to the blast effect and a large number of residual foreign bodies in the wound. This study analyzed the medical records of patients' who had hand injuries caused by mole guns and presents our approach through a reconstruction algorithm. Data from 19 consecutive patients who sustained mole gun injuries between March 2015 and May 2019 were reviewed in this retrospective study. Demographics, affected tissues at the injury site, surgical treatment, presence of foreign bodies, and postoperative complications were recorded. A treatment algorithm was created based on the results of this study. Six patients underwent one operation, while the remaining 13 underwent more than one operation. A bone defect was found in four patients, skin and soft tissue defects in six patients, and a neurovascular defect in six patients. Two or less foreign bodies were seen in seven patients. Foreign body removal and debridement procedures are important in the first surgical session. The repair of defectless structures during the same session is also essential. Preparation of the structures with defects that will be repaired 5-7 days later simplifies the secondary surgery.