A 28-year-old man sustains a gunshot wound to the right thigh with a 1 cm entry and 4 cm exit wound, significant soft tissue damage, and a comminuted femoral fracture. Foot is warm with palpable pulses. What is the most appropriate wound management?
- A Primary closure of both wounds
- B Packing and dressing only
- C Debridement and delayed primary closure ✓
- D Immediate intramedullary nailing
Correct answer: C. Debridement and delayed primary closure
Explanation
High-energy gunshot wounds with significant soft tissue damage require thorough debridement of all devitalized tissue followed by delayed primary closure. Primary closure is contraindicated in contaminated wounds with tissue loss because of high infection risk. Definitive fracture fixation follows adequate wound debridement.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.