A 66 year old male (ZZ) shot himself in the left quadriceps with a gun. The entry wound was on the top of the left quadricep, and the exit wound was on the lateral lower quadrant of the quadricep.  Gunshot wounds (GSW) have no standard treatment regimen consistently documented in the literature. The goal of ZZ’s treatment was to close the wound as soon as possible, and not develop a secondary infection.  One confounding factor in this case was that ZZ felt compelled to keep this injury confidential secondary to his feelings of shame as related to gun safety.

Polyhexamethylenebiguanide (PHMB) impregnated Gauze was the treatment selected for ZZ.  This dressing has been demonstrated to control growth of a broad spectrum of bacteria.  This dressing has demonstrated kill efficacy of at least 48 hours.  Because this patient refused to perform his own wound care or to accept support from his family or other outside resources, and because ZZ refused other deep wound closure therapy, we began a three time per week dressing change regimen with the product described.  ZZ demonstrated wound closure in 88 days with this treatment.

PHMB impregnated dressings may be a reasonable alternative for traditional wound care for GSW’s.