Gunshot wound microflora: the influence on clinical outcomes

The aerobic microflora of gunshot bullet-induced femoral and lower leg fractures has been studied in a group of 47 wounded persons. Severe wounds were predominating with the presence of foreign metal bodies in the wound. The interval duration between the wounding and the onset of specialized care rendering varied from 2 to 70 hours. Primary stabilization of gunshot fractures after debridement was performed with external fixators in 34 wounded persons. The wounds were not sutured, they were treated with antiseptic dressings. Inoculation from the wound was made before debridement and 72 hours after it. The primary prevailing flora was represented by Staph. Aureus, which further was replaced by saprophytic flora (Staph. epidermidis, E. coli, P. aeruginosa), having become the cause of complications (osteomyelitis, wire tract infection) in 6 wounded persons out of 8 ones. There were no strong correlations between the duration of the period from injury to debridement, the degree of wound bacterial contamination and the purulent complications of gunshot fracture.