Gunshot wound to the foot: early management and pathophysiology of projectile wounds

The authors present a case study of gunshot wound and discuss the rationale for therapy after hemostasis is established. Treatment consists of debridement of necrotic tissue, immobilization to prevent further movement of the bullet, and immediate antibiotic therapy to prevent bacterial invasion. They emphasize the necessity of understanding the pathomechanics and pathophysiology of ballistic injuries and advocate removal of the bullet, when possible, to relieve discomfort, to prevent anemia and renal failure, and to avoid the danger of lead intoxication.