Characteristics and Outcomes Among Patients with Acute Extremity Wounds Due to Gunshots Versus Bomb Blasts – A Prospective Cohort Analysis from Two Civilian Hospitals in Iraq and Jordan

Introduction: Gunshots and bomb blasts are important causes of injury within conflict zones extremities frequently affected. There is a paucity research on the characteristics outcomes among civilians with conflict-related extremity injuries. Method: We performed prospective cohort analysis utilizing data collected during randomized trial at two civilian hospitals in Jordan Iraq between 2015 2019. Adult patients who presented 72 hours sustaining an requiring surgical care were included. used mechanism (gunshot versus blast) as exposure wound closure by day five primary outcome measure. Results: The population was predominantly young men (n=163, 94% male, median age 29 years), injured gunshots (61%) or (39%). Compared to gunshot group, participants blast group had more concomitant injuries (32/63 [51%] vs 11/100 [11%]; p<0.001), larger wounds (median area 100 cm 2 [IQR 50–145] 53 cm2 25–78]; p<0.001) frequent infections (16/63 [25%] 13/100 [13%]; p=0.04). Wound achieved 25% (n=16/63) 74% (n=74/100) (p<0.001). This difference remained after controlling for confounding factors (OR 4.7; 95% CI 1.6–13.7). Conclusion: In this first acute conflict-associated injuries, those caused worse than wounds. Our findings may prove useful inform treatment protocols armed settings.