Heridas por asta de toro en el Hospital General de Castellón. Estudio de 387 pacientes / Bull horn wounds in Castellon General Hospital. A study of 387 patients

Las heridas por asta de toro son frecuentes en el mundo iberoamericano, donde los espectáculos con estos animales son algo habitual. Dichas heridas presentan unas características especiales que las diferencian de cualquier otro tipo de heridas. Material y método: Se realizó un estudio retrospectivo con revisión de las historias clínicas de los pacientes ingresados en nuestro servicio con el diagnóstico de herida por asta de toro entre enero de 1978 y octubre de 2005. Resultados: Se estudiaron 387 ingresos. En 12 ocasiones se trató de reingresos por nuevas cogidas en un mismo paciente. En 27 enfermos se presentaron múltiples heridas. La localización de las heridas principales fue: cabeza y cuello 12 (3,1%), tórax 21 (5,4%), extremidades superiores 19 (4,9%), abdomen 44 (11,3%), periné 41 (10,5%), región lumbar-espalda 6 (1,5%) y extremidades inferiores 244 (63%). Fueron necesarias 31 laparotomías con 23 lesiones viscerales. Aparte del tratamiento específico, se realizó lavado con solución antiséptica, Friedreich y sutura de piel sobre drenajes, tratamiento antibiótico y vacunación antitetánica. Las complicaciones inmediatas más frecuentes fueron la desvitalización de la herida y la infección, con 7 y 6 casos, respectivamente. La complicación tardía más frecuente fue la eventración con 6 casos. Hubo 3 muertes por shock hipovolémico, por shock séptico y por gangrena gaseosa. Conclusión: Las heridas por asta de toro tienen unas características propias que es necesario conocer especialmente en regiones con afición al toreo. Aunque son lesiones graves, su pronóstico es bueno, con escasas complicaciones y una mortalidad menor del 1% (AU)

Bull horn lesions are frequent in the Latin world due to spectacles involving these animals. These wounds have special characteristics that distinguish them from all other lesions. Material and method: A retrospective analysis of the medical records of patients with bull horn lesions admitted to our service between January 1978 and October 2005 was performed. Results: A total of 387 patients with bull horn lesions were admitted to our service. There were 12 readmissions due to a new wound in a previously treated patient. Twenty-seven patients had two or more lesions. The location of the wounds was: head and neck in 12 (3.1%), thorax in 21 (5.4%), upper extremities in 19 (4.9%), abdomen in 44 (11.3%), perineum in 41 (10.5%), back and lumbar region in 6 (1.5%), and lower extremities in 244 (63%). Thirty-one laparotomies were performed and there were 23 visceral lesions. Surgical treatment in addition to specific procedures consisted of irrigation with antiseptic solution, Friedreich, and primary closure over drains. Antibiotic and antitetanus vaccinations were administered in all patients. The most frequent early complications were: wound devitalization (7 patients) and infection (6 patients). The most frequent late complication was incisional hernia. Three patients died as a result of hypovolemic shock, septic shock and gas gangrene. Conclusion: Bull horn wounds have special characteristics. Familiarity with these lesions is important in areas where bullfighting is practiced. Although bull horn wounds are severe, their prognosis is good, with few complications and a mortality rate of less than 1% (AU)

[Bull horn wounds in Castellon General Hospital. A study of 387 patients]. / Heridas por asta de toro en el Hospital General de Castellón. Estudio de 387 pacientes.

UNLABELLED: Bull horn lesions are frequent in the Latin world due to spectacles involving these animals. These wounds have special characteristics that distinguish them from all other lesions. MATERIAL AND METHOD: A retrospective analysis of the medical records of patients with bull horn lesions admitted to our service between January 1978 and October 2005 was performed. RESULTS: A total of 387 patients with bull horn lesions were admitted to our service. There were 12 readmissions due to a new wound in a previously treated patient. Twenty-seven patients had two or more lesions. The location of the wounds was: head and neck in 12 (3.1%), thorax in 21 (5.4%), upper extremities in 19 (4.9%), abdomen in 44 (11.3%), perineum in 41 (10.5%), back and lumbar region in 6 (1.5%), and lower extremities in 244 (63%). Thirty-one laparotomies were performed and there were 23 visceral lesions. Surgical treatment in addition to specific procedures consisted of irrigation with antiseptic solution, Friedreich, and primary closure over drains. Antibiotic and antitetanus vaccinations were administered in all patients. The most frequent early complications were: wound devitalization (7 patients) and infection (6 patients). The most frequent late complication was incisional hernia. Three patients died as a result of hypovolemic shock, septic shock and gas gangrene. CONCLUSION: Bull horn wounds have special characteristics. Familiarity with these lesions is important in areas where bullfighting is practiced. Although bull horn wounds are severe, their prognosis is good, with few complications and a mortality rate of less than 1%.