Penetrating and Basilic Trauma of the Thorax in a Context of Difficult Diagnosis at the Pediatric Hospital of Bangui (Central African Republic)

Appropriate management of penetrating trauma to the thorax requires knowledge of vulnating agents, as well as the principles of ballistic injury. The importance of the approach’s choice for surgical exploration of these injuries, and parietal damage, is an essential factor in decision making in the management and definition of the therapeutic strategy for these injuries. The authors report a clinical case of a penetrating traumatic ballistic wound of the thorax managed in a context of difficult diagnosis in the surgical Unit of the CHUPB.

Microsurgical repair at early stage for soft tissue defect of limbs wounded by modern firearm

Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.

Emergency treatment of craniocerebral firearm wounds

Objective: To improve the outcome of treatment in patients with craniocerebral firearm wound. Methods: Prospectively and retrospectively reviewed a series of 93 patients presented to the Xi Jing Hospital of Fourth Military Medical University with a diagnosis of craniocerebral firearm wound during a period of 27 years from July 1970 to July 1997. All the patients had acute craniocerebral firearm wound. Of these, it consisted of 81 males (87.1%) and 12 females (12.9%) ranging from 3 months to 58 years in age (median 24.6 years). The lesion included 16 tangential wounds, 58 tubular wounds and 19 through and through wounds. The cases were urgent and in serious and unstable condition. All the patients underwent surgical intervention and aggressive perioperative management in the neurosurgical intensive care, including resuscitative protocols. Results: After emergency treatment and operation, 9 cases died (9.7%). Follow up studies at three months postoperative showed that 56 cases (66.7%) had made good recovery. Rates of moderate disability, severe disability or vegetative state in this series were 19.0%, 10.7% and 3.6 %, respectively. Long term follow up studies (median 5.5 years) found that 42 (50.0%) were capable of resuming their occupation. Conclusions: Craniocerebral firearm wounds are often severe, needing urgent treatment for the patients. Timely, proper and thorough initial debridement are crucial for avoiding rapid neurological deterioration.