Gunshot Wounds: A Surgical Approach

by Dr Aparajeya Shanker, MD

Recently, I had the privilege of being invited to the Medical University Pleven Surgery Society for a talk on Gunshot Wounds. Although the topic is vast and complex, it is an essential aspect of life as a junior doctor, and unfortunately, it has become an issue of increasing concern over the past few years.

My main takeaways for the attendees can be summarized in three points:

1. Tie A Tourniquet: Tying a tourniquet is essential for controlling hemorrhage and this is often the most obvious and most important step to take for Gunshot victims.

2. Use a three-way chest valve/seal: The primary goal in thoracic wounds is to prevent pulmonary collapse if possible. This is especially true in preventing or reducing a pneumothorax. This is best achieved with a three-way chest valve, as this acts as a valve to prevent air from entering into the thorax.

3. Debridement is essential especially in the context of massive tissue loss. Debridement allows us to assess the state of the tissue, and forms the foundation upon which surgical intervention can be made. It is also essential to understand that debridement and tissue handling can lead us to appropriate reconstruction later on.

I have attached a copy of the presentation here:

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Also, I would like to take this opportunity to direct you to a useful resource on surgery: