La prise en charge des infections des plaies par arme à feu dans les hôpitaux universitaires civils et un hôpital d'instruction des armées, à Marseille

Abstract : Context: Infections are known complications of gunshot wounds, and participate in their morbi-mortality. Wars in Iraq and Afghanistan mainly provided epidemiologic military studies, but there are fewer of civilian studies on this subject. Methods: We performed a retrospective study of civilian patients admitted for gunshot injuries in three public university hospitals and in one military hospital in Marseille, France. We wanted to describe, the management of the civilian’s ballistic wounds in a major city in France, study the rate and types of infections complicating them, and evaluate potential factors associated with infection. Results: From 1995 to 2017, 265 civilian cases of gunshot wounds were admitted in our centers. 27% of cases developed infection with half being osteomyelitis, and 30% cases relapsed. The most frequent bacteria were Staphylococcus aureus, Enterobacter cloacae, Pseudomonas aeruginosa or Escherichia coli. In the univariate analysis, injury by accident, by birdshots or buckshot, arm or ankle location, extensive damage, Gustilo IIB or IIIC fractures and early closure of the wound were associated with risk of infection. Conclusion: One quarter of civilian gunshot injuries developed infection in our study. The wounds associated with risk factor of infection should, in addition to careful and experimented surgical care, have an early probabilistic antibiotherapy active against the most frequent bacteria found.
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https://dumas.ccsd.cnrs.fr/dumas-02090120
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Submitted on : Thursday, April 4, 2019 - 2:42:09 PM
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Chloé Creusefond. La prise en charge des infections des plaies par arme à feu dans les hôpitaux universitaires civils et un hôpital d'instruction des armées, à Marseille. Sciences du Vivant [q-bio]. 2018. ⟨dumas-02090120⟩

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