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Gunshot wounds - aftercare

Description

A gunshot wound is caused when a bullet or other projectile is shot into or through the body. Gunshot wounds can cause serious injury, including:

• Severe bleeding
• Damage to tissues and organs
• Broken bones
• Wound infections
• Paralysis

The amount of damage depends on the location of the injury and the speed and type of bullet. Gunshot wounds to the head or body (torso) are likely to cause more damage. High-velocity wounds with fracture are associated with an increased risk of infection.

Wound Care

If the wound was severe, you may have had surgery to:

• Stop bleeding
• Clean the wound
• Find and remove bullet pieces
• Find and remove pieces of broken or shattered bone
• Place drains or tubes for body fluids
• Remove portions of, or whole, organs

Gunshot wounds that pass through the body without hitting major organs, blood vessels, or bone tend to cause less damage.

You may have bullet pieces that remain in your body. Often these cannot be removed without causing more damage. Scar tissue will form around these remaining pieces, which may cause ongoing pain or other discomfort.

You may have an open wound or a closed wound, depending on your injury. Your health care provider will tell you how to change your dressing and care for your wound. Keep these tips in mind:

• Keep the dressing and area around it clean and dry.
• Take any antibiotics or pain relievers as directed. Gunshot wounds can get infected because material and debris can get pulled into the wound with the bullet.
• Try to elevate the wound so it is above your heart. This helps reduce swelling. You may need to do this while sitting or lying down. You can use pillows to prop up the area.
• If your provider says it is OK, you may use an ice pack on the bandage to help with swelling. Ask how often you should apply the ice. Be sure to keep the bandage dry.

Your provider may change your dressing for you at first. Once you get the OK to change the dressing yourself:

• Follow instructions on how to clean and dry the wound.
• Be sure to wash your hands after removing an old dressing and before cleaning the wound.
• Wash your hands again after cleaning the wound and applying the new dressing.
• Do not use skin cleansers, alcohol, peroxide, iodine, or soaps with antibacterial chemicals on the wound unless your provider tells you to. These can damage the wound tissue and slow your healing.
• Do not put any lotion, cream, or herbal remedies on or around your wound without asking your provider first.

If you have non-dissolvable stitches or staples, your provider will remove them within 3 to 21 days. Do not pull at your stitches or try to remove them on your own.

Bathing or Showering

Your provider will let you know when it is OK to bathe after you come home. You may need to take sponge baths for several days until your wound has healed enough to shower. Keep in mind:

• Showers are better than baths because the wound does not soak in the water. Soaking your wound could cause it to reopen.
• Remove the dressing before bathing unless told otherwise. Some dressings are waterproof. Or, your provider may suggest covering the wound with a plastic bag to keep it dry.
• If your provider gives you the OK, gently rinse your wound with water as you bathe. Do not rub or scrub the wound.
• Gently pat dry the area around your wound with a clean towel. Let the wound air dry.

After Effects

Being shot by a gun is traumatic. You may feel shock, fear for your safety, depression, or anger as a result. These are completely normal feelings for someone who has been through a traumatic event. These feelings are not signs of weakness. You may notice other symptoms as well, such as:

• Anxiety
• Nightmares or trouble sleeping
• Thinking about the event over and over
• Irritability or being easily upset
• Not having much energy or appetite
• Feeling sad and withdrawn

You need to care for yourself and heal emotionally as well as physically. If you feel overwhelmed by these feelings, or they last more than 3 weeks, contact your provider. If these symptoms are ongoing, they may be signs of post-traumatic stress disorder, or PTSD. There are treatments that can help you feel better.

When to Call the Doctor

Call your provider if:

• Pain gets worse or does not improve after taking pain relievers.
• You have bleeding that will not stop after 10 minutes with gentle, direct pressure.
• Your dressing comes loose before your provider says it is OK to remove it.

You should also call your doctor if you notice signs of an infection, such as:

• Increased drainage from the wound
• Drainage becomes thick, tan, green, or yellow, or smells bad (pus)
• Your temperature is above 100°F (37.8°C) or higher for more than 4 hours
• Red streaks appear that lead away from the wound

References

Simon BC, Hern HG. Wound management principles. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 50.

Zych GA, Kalandiak SP, Owens PW, Blease R. Gunshot wounds and blast injuries. In: Browner BD, Jupiter JB, Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 20.

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Review Date: 4/16/2022  

Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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