Self-Inflicted Gun Shot Wound to the Hand in Partner Forces – Part 1

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Background

  • 26-year-old right hand dominant male Afghan, member of the Afghan Local Police (ALP).
  • Self-inflicted gun shot wound to left hand, presented for treatment within 8 hours to the Forward Operating Base surgical team.
  • Decreased sensation median nerve distribution, intact radial and ulnar nerve sensation.
  • Brisk capillary refill was less than 2 seconds inall digits (perfusion adequate). 
  • Motor exam not possible due to pain.

Pre operative

fig 1

fig 2

Operation proceeded within an hour after presentation. 

In the austere environment, what should be done for this patient?

What are the goals of surgery?

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