Abstract
Since March 2018, MSF clinics in Gaza have treated thousands of patients affected by complex gunshot wounds at risk of complications, requiring advanced orthopedic surgery.
INTRODUCTION
Since March 2018, weekly demonstrations and Israeli army reaction in Gaza have led to thousands of casualties. MSF-OCP adapted its programmes in the strip to provide care to gunshot-wounded. Here we describe the medical and surgical needs of trauma patients.
METHODS
This retrospective analysis includes all gunshot or explosion related trauma patients admitted into MSF–OCP clinics of Gaza between 1st April and 30th September 2018. We included all patients enrolled into MSF-OCP clinics because of a gunshot/explosion trauma, starting 30th March or later. We extracted data from patients’ files and registers. We calculated mean and standard deviation (SD) for numeric variables and proportions for categorical variables.
RESULTS
Of the 1 957 patients included, 70 were admitted more than once, totalling 2 027 enrollments. Of these, 1 923 (98%) were male with a mean age
of 25 years (SD 6); 1 932 (99%) were the result of gunshots. Of 1 048 (54%) patients with a bone fracture, 956 (91%) were in the lower limbs and 620 (59%) had an internal or an external fixation. We counted 235 (12%) and 181 (9%) patients with vascular and nerve injuries, respectively. Overall, 24 236 dressings, 13 133 physiotherapy sessions and 649 surgical interventions were performed. At the end of September, 807 (40%) patients were still on follow-up, and 647 (54%) had been discharged with maximum benefit achieved. Of the 478 (39%) defaulters, 174 (36%) dropped out within 7 days.
CONCLUSIONS
This analysis shows an extremely high number of young patients affected by complex gunshot wounds, at high risk for complications and sequelae,
and who received high intensity care in one the MSF-OCP clinics. It argues for the need for advanced orthopedic and reconstructive care.
The high proportion of dropouts suggests the need to investigate further and to adapt the project accordingly to patients.
