Most bullets made of lead alloy


Oral antibiotics for 72 hours as effective as IV



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Oral antibiotics for 72 hours as effective as IV

  • IV antibiotics not indicated unless for prophylaxis for surgery

  • If perforate bowel and injure joint, consider irrigation and debridement



  • Higher incidence of infection

    • Higher incidence of infection

        • Knapp et al, JBJS, 1996
    • Consider operative debridement, especially if antero-medial wound



    Arterial injury can occur from:

    • Arterial injury can occur from:

      • Direct contact
      • Cavitation
      • Associated fractures
    • Evaluation



    Ankle-brachial index (ABI) <.90



    Pulses absent

    • Pulses absent

    • Discrepant pulses

      • If ABI < .90 angiography to look for lesion
      • If ABI > .90, serial documentation of limb vascularity necessary



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