PMC4600867_01
Gunshot wound with arrow pointing at the bullet exit.
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fig1
T7 spine level measuring about 5 cm in diameter (Figure 1). The wound was managed with serial surgical debridement. Tissue taken for culture and sensitivity grew Escherichia coli sensitive to cefuroxime among other antibiotics.
Perforator fasciocutaneous flap with arrow pointing to the blood vessels.
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fig2
A fasciocutaneous flap was then fashioned on this perforator (Figure 2).
Island latissimus dorsi segmental muscle flap.
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fig3
A segment of the muscle was then raised as an island flap based on one of the vessels through the paraspinous muscle (Figure 3).
Latissimus dorsi muscle inserted into the defect.
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fig4
The muscle flap was then mobilized and used to fill the dura and the muscle defect over the spine in two layers (Figure 4).
Wound completely covered with the fasciocutaneous flap with a drain in situ.
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fig5
A closed drain was put between the two flaps (Figure 5).
Wound fully healed 2 weeks after surgery.
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fig6
There were no complications and the wounds had healed completely at about two weeks after surgery (Figure 6).