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Analysis of Risk Factors for Gunshot Wound Infection in a Nigerian Civilian Trauma Setting

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Abstract

Background

Survivors of firearm injury are at risk of wound infection. On average, civilian gunshot wound infection rates in developing countries are relatively high and almost on a par with infection rates in war trauma settings. Overall, there are limited data on civilian gunshot wound infection and its predisposing factors. The aim of this study was to determine the risk factors for gunshot wound infection in a civilian trauma setting of a developing nation.

Materials and method

This was a retrospective analysis of data on the entire patients who presented in Federal Teaching Hospital Abakaliki with firearm injury from January 2005 to December 2014.

Results

There were 196 patients, and wound infection was a complication in 58 (29.6 %) of them. The significant factors for high wound infection rate in univariate analysis were perforating wound (p < 0.001), high velocity injury (p < 0.001), haematocrit <30 % (p < 0.001), presence of fracture (p < 0.001), hollow viscus injury (p < 0.001) and injury to hospital arrival interval later than 6 h (p < 0.014). Anatomical site of injury correlated with infection rate (p < 0.001), highest rate (40.6 %) in lower extremity and least (9.1 %) in head and neck wounds. Multivariate logistic regression analysis identified haematocrit (p < 0.001), perforating wound (p < 0.021), presence of fracture (p < 0.043) and hollow viscus injury (p < 0.039) as independent predictors of gunshot wound infection.

Conclusion

The independent predictors of infection identified in this study call for judicious replacement of blood loss and high priority accorded to perforating wound, fractures and hollow viscus injury in interventions aimed at reducing gunshot wound infection rate.

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Acknowledgments

I thank Dr. Uche Emmanuel Eni, Chief Consultant General Surgeon Federal Teaching Hospital Abakaliki for reading the manuscript and offering suggestions and corrections.

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  1. Department of Surgery, Ebonyi State University/Federal Teaching Hospital, PMB 102, 480001, Abakaliki, Nigeria

    Njoku Isaac Omoke

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  1. Njoku Isaac Omoke
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Correspondence to Njoku Isaac Omoke.

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Omoke, N.I. Analysis of Risk Factors for Gunshot Wound Infection in a Nigerian Civilian Trauma Setting. World J Surg 40, 1885–1891 (2016). https://doi.org/10.1007/s00268-016-3475-4

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  • DOI: https://doi.org/10.1007/s00268-016-3475-4

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