Most bullets made of lead alloy

Look for expanding hematoma

X-rays of injured extremities and areas

Angiography when necessary

• Discrepancy of pulses

Low velocity gunshot wounds rarely need debridement

• Low velocity gunshot wounds rarely need debridement

• High velocity and close range shotgun wounds always need debridement

• Most civilian gunshot wounds are low velocity and low energy

Old myth that bullet was sterile from heat

• Old myth that bullet was sterile from heat

• Wolf et al:

• Coated bullet with S. aureus and shot into sterile gelatin block
• Positive cultures grew from gelatin

Low velocity gunshot wounds in stable fractures do not need surgical debridement

• Low velocity gunshot wounds in stable fractures do not need surgical debridement

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