The Journal of urology
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The Journal of urology · Apr 2004
ReviewBallistics for physicians: myths about wound ballistics and gunshot injuries.
Wound ballistics is a difficult subject. The behavior of all bullets is unpredictable but the specific effect of high velocity projectiles has been a particular source of confusion in the literature. This confusion has resulted in the likely incorrect conclusion that all high velocity wounds require massive débridement. We reviewed the entirety of the literature on this subject and concluded that high velocity weapons do not reliably create massive wounds, and judicious débridement and staged explorations may be the best treatment method for these patients. ⋯ For the majority of high velocity gunshot wounds, especially military rifles that generally fire a projectile that is meant to stay intact after impact, wound severity can be limited, even much less than that from a civilian rifle, shotgun or handgun. Judicious use of débridement during surgical exploration limits the extent of iatrogenic injury in the surgical care of these patients.