Nineteen children who had open fractures and skin wounds of at least two
centimeters due to shrapnel were followed for one to five weeks after they
had been injured. All of the patients were managed with debridement at
twenty-four to forty-eight-hour intervals and were given cephalosporin
antibiotics. Fourteen patients did well. The wounds in the three patients
who had the least severe soft-tissue injury were healing well at two weeks,
and ten other patients were progressing to soft-tissue and osseous healing
at five weeks. One patient had progressive but slower healing, and plastic
reconstructive procedures would be advisable. Five patients had major
problems. In one of these children, a wound continued to drain after six
weeks. Three children had an amputation, and another child died due to a
vascular injury.