Gun Shot Wound
Case Study

35 y/o male transported to ER by EMS for multiple gun shot wounds. No significant past medical history. Patient is unresponsive from trauma, blood loss, and abdominal gun shot wound. The trauma team performs their assessment and finds 3 GSWs: thigh, abdomen, and foot. The patient is taken for emergent exploratory lap and requires resection of 1 kidney and portion of his liver due to bleeding. He is transported to trauma ICU and you are consulted to assist in managing the foot wound with retained bullet. On exam you see the entry wound at lateral hallux and 1st intermetatarsal space with deep probing contaminated wound site. X-rays are below:

Given the critical nature of this patient, you are told that going to the OR for his foot is not an option and may not be an option for several days. What is your short term and long term plan for this patient?

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John Steinberg, DPM
Editor - PRESENT