GUNSHOT WOUNDS OF THE SPINE - SHOULD RETAINED BULLETS BE REMOVED TO PREVENT INFECTION

We have investigated the role of retained bullets and other possible r isk factors in the development of local septic complications after gun shot wounds (GSW) of the spine. Of 153 patients with GSW of the spine followed up for a mean of 28 months, the overall incidence of bullet w ound related septic complications was 9.8%. In 81 patients the bullet was retained and the incidence of local septic complications was 7.4%. In 72 patients the bullet left the body (70) or was removed on admiss ion (2), and the sepsis rate was 12.5% (P>0.05). In 24 patients there was an associated colonic injury and the incidence of sepsis was 8.4% compared with 5% in the group of patients with intra-abdominal injurie s but no colonic trauma (P>0.05). The incidence of septic complication s in lumbar spine injuries was significantly higher than in thoracic a nd cervical spine injuries (P>0.05). We believe that in GSW of the spi ne, retained bullets do not increase the likelihood of septic complica tions