Biological Approach for Managing Severe Gunshot Wounds

A Case Report

Abstract

BACKGROUND: 

Autologous formulations rich in bioactive proteins promote cutaneous tissue regeneration. This case report describes our experiences with a platelet-based autologous formulation in the management of a hard-to-heal and severe gunshot wound.

CASE: 

A healthy, 34-year-old man suffered an accidental gunshot wound of his right foot. After cleansing with saline and application of vacuum-assisted closure therapy for a period of 5 weeks, the resulting full-thickness wound had a surface area of 20 cm² and did not show progress toward closure despite ongoing treatment. Plasma-rich growth factor (PRGF) therapy was used in order to promote tissue regeneration. The patient's own blood was drawn, centrifuged, and platelet-rich plasma was obtained. Intradermal injections of freshly activated platelet-rich plasma were administered into the wound edges, and a fibrin membrane was applied on the wound bed. Afterward, a novel topical ointment based on the patient's own growth factors was used as a daily therapy over the affected tissue.

RESULTS: 

This full-thickness wound healed after 16 weeks of autologous growth factor therapy. The patient was able to walk without pain.

CONCLUSION: 

Plasma-rich growth factor therapy successfully healed this full-thickness wound that did not respond to a period of 5 weeks with negative pressure wound therapy using a vacuum-assisted device. Healing occurred after 16 weeks of treatment, and he was able to resume walking without pain or functional deficits.