Gun Shot Wounds/Crush and Lawnmower Injuries
High energy wounds.
Gross contamination is the rule.
Intravenous fluids; check for shock; assess degree of skin, neural, vascular and bony injury; cultures; tetanus prophylaxis; parental broad-spectrum antibiotics.
Surgical – debride necrotic and contaminated tissue; stabilise with external/internal fixation; split-thickness skin grafts for skin deficits