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Wound ballistics: analysis of blunt and penetrating trauma mechanisms

Panagiotopoulos Elias

Background: The tissue factors important in wound ballistics provide a useful insight into the pathophysiology of organ injury in all traumas. Wound ballistics includes penetrating and blunt trauma mechanisms. Although the mechanism of a traumatic event may be pure blunt or penetrating trauma, the mechanism of tissue injury may be mixed. The aim of the present study was to review the literature about Blunt and Penetrating Trauma Mechanisms. Method and Material: The method that was used for the realization of the research is the search of articles, researches and papers to the internet (MEDLINE, EMBASE and CINAHL databases) in order to become a review of the Hellenic and the foreign bibliography from 1988 until today. Results: The varied ability of different types of tissue to tolerate the physical displacement of tissue stretch in gunshot wounds and the inability of any tissue to survive being crushed by a bullet is a model for the relative abilities of different tissues to tolerate blunt trauma and penetrating trauma of all types. Center-fire rifle bullets crush tissue as they pass through it, as does any penetrating trauma agent. This crushed tissue does not survive. Center-fire rifle bullets also cause blunt trauma by tissue displacement (temporary cavitation). The ability of different tissues to survive this blunt trauma is related primarily to tissue elasticity and cohesiveness. Conclusions: The blunt and penetrating trauma aspects of wound ballistics can be used to explain the response of all tissue to blunt and penetrating trauma of all types, assisting in predicting and explaining the severity or lack of severity of tissue injury in trauma in general.