Shrapnel wounds in children.

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 débridement 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.