[Gunshot and Blast Injuries from a Trauma Surgery Perspective].

Abstract

The severity and extent of gunshot and blast injuries are often misjudged due to a lack of specialist knowledge. The aim of this article is to outline the characteristics of gunshot and blast injuries, including emergency diagnostics and initial surgical treatment.Due to multiple high-energy penetrating injuries, barotrauma, or blunt trauma, affected patients are usually polytraumatized, with multiple organ damage and an average Injury Severity Score (ISS) of > 36. In addition to the complexity of the wounds, they are characteristically severely contaminated. After pre-hospital treatment, life-threatening injuries and conditions should be identified and initially treated in the trauma room phase. The procedure should be based on a standardized, internal hospital emergency medical and emergency surgical algorithm. Damage control surgery can then be used to treat acutely life-threatening complications of gunshot and blast injuries in order to prevent the fatal triad and the occurrence of further early complications. Examples of interventions include debridement and decontamination, fracture stabilization (external fixators and splints), surgical decompression (skull, thorax, compartment syndromes) and surgical hemostasis.