PMC4801091_01
Gross bullet fragments seen in chest and bilateral breasts. Wound vacuum dressing placed on left forearm.
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F1
The patient was shot multiple times resulting in numerous projectile fragments located in the chest, bilateral breasts, and left upper and lower extremities (Fig. 1). A few days later, the patient underwent irrigation and debridement of the wounded areas, open reduction and internal fixation of the left radius, and wound vacuum dressing placement to the left forearm (Fig. 1).
Gross open forearm status post-gunshot trauma to forearm.
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F2
Upon close inspection of her forearm, she was missing 8 x 8 cm of skin, subcutaneous fat, and muscle with evidence of exposed extensor tendons (Fig. 2).
Detailed constructed pedicled left breast flap to forearm pictured.
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F3
The novel approach of a left pedicled breast flap was employed to provide durable soft tissue coverage of her wound (Fig. 3).