Shotgun wound management: a comparison of slug and pellet injuries

Shotgun slug injuries have received little attention while shotgun pellet wounds have been well described. Twenty-two shotgun pellet and 13 shotgun slug injuries treated over a 14-year period were retrospectively reviewed. Extremity and thoracic wounds were most frequent in both groups. The incidence of vascular and nerve injuries was similar for slug and pellet wounds. Angiography was more often used to evaluate pellet wounds for vascular disruption. The rate of wound infection was 38% for slug wounds versus 32% for pellet injuries. Tissue grafting was more frequently necessary for reconstruction after pellet injury. Long-term disability was documented in 15% of patients with pellet wounds and 23% with slug wounds. Despite similarities in wound location and outcomes, the ballistic differences between shotgun slugs and pellets resulted in significant differences in wounding characteristics and extent of injury which have important ramifications in management.