07-14-2011, 12:18 PM
RangerRick Wrote:Yeah, in my case they stopped the bleeding and left the wounds open for about 10 days, a trick they learned in Vietnam. No sense stitching infection in. They changed my dressings every other day and just spackled Betadine paste into the wound holes with a tongue depressor. Then another trip to the OR for 300+ stitches and skin grafts.
I don't know what the relative speed of the shrapnel was but I suspect it was pretty slow. I was 10 or 15 feet from the blast. So I wonder if a slower or faster projectile would have a tendency to take cloth with with it rather than punching a clean hole in the cloth.
When you have large wounds, especially traumatic or surgical amputations, it is smart to clean the wounds like that, and do a 10-day delayed primary closure as you described. I saw a pretty good video on this with a mine victim from Afghanistan in the 1990's. His legs were totally intact, but perforated with dozens of small serrated wire fragments from an AP mine. Both his legs were amputated in the video with interlocking "U" cuts, his femurs filed down so they wouldn't lacerate the internal tissues after closure, and he was given the same delayed primary closure protocol you got for 10 days.
The "U" flaps were then sutured together, and prosthetics fit to him. Had he received immediate attention for the small wounds, with a strong antibiotic drip and cleaning of the individual wounds, he would have likely retained his legs with no serious limitations on function, unless his joints were perforated.
The key thing with perforating injuries is proper medical care ASAP. The longer you delay, the sooner infection sets in, and then anything can happen.
LRRPF52