Gunshot Wound Contamination with Squirrel Tissue: Wound Care Considerations

While report of animal bites contaminating wounds is reported commonly, direct wound contamination with squirrel flesh has never been reported in the literature. The patient suffered an accidental self-inflicted gunshot wound that drove squirrel flesh and buck shot deep within his right buttock. This case outlines his hospital course and wound treatment. The patient was treated with ten days of broad spectrum antibiotics, extensive debridement of the wound in the operating room, and further treatment of the wound with a vacuum dressing system. While squirrel tissue and buckshot had to be removed from the wound on day six of the hospital stay, the patient remained afebrile without signs or symptoms of systemic illness. 1. Introduction Penetrating injuries account for up to twenty percent of all pediatric trauma admissions, and gunshots are the most common mechanism of injury in these patients [1]. Traditionally, civilian gunshot wounds are not at high risk for infection, regardless of the projectile’s passage through clothing. However, the inclusion of animal tissue inside of the wound itself is a unique consideration. Animal inflicted wounds, such as bites and abrasions, are a common occurrence, with an annual incidence of 1-2 million, and carry a risk for zoonotic infections [2]. In particular, squirrels, as part of the rodent family, carry the potential to harbor a high number of pathogens capable of infecting a human. While most infections from rodents occur via either direct contact (i.e., a bite) or due to indirect contamination (via an arthropod vector), gross contamination of an open wound with squirrel flesh is an unreported event [3]. 2. Case Presentation The patient was a teenage Caucasian male with no significant past medical history who arrived to the Emergency Department (ED) via ambulance with a complaint of gunshot wound to the right buttock approximately one hour prior to arrival. According to the patient he was using the butt of his 12？G shotgun to dislodge a dead squirrel from a branch over his head during a hunting trip and shot himself with a load of birdshot in the right buttock. He presented with stable vital signs and reported no pain other than at the wound. On physical exam the patient appeared in no distress with mild tachycardia with a heart rate of 116. A ？cm deep wound on the right buttocks was hemostatic (Figure 1). The edges of the wound were black and ragged, while there was circumferential surrounding erythema that extended 4？cm beyond the wound. Rectal exam revealed normal tone without gross blood and no palpable