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7/29/2019 Gunshot & Shrapnel Wounds.pptx
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Gunshot & Shrapnel
Wounds
Ada Gay O. Serencio, RN
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Types of Firearm1. Revolver
2. Automatic Pistol3. Rifle
4. Shot Gun
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Characteristics & appearance of
Gunshot wounds are influenced by thefollowing factors:
1. Kind of weapon
2. Caliber of weapon
3. Shape and composition of themissile
4. Range of fire
5. Direction of fire6. Parts of the body involved
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Entry wounds are categorized
based on range Contact: muzzle is pressed against the
skin when fired
In areas of loose skin (abdomen, chest):
circular wound with blackened, seared skin
margins
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On head, where the scalp is tightly covering theskull, entry wounds can have several different
appearances:
Round wound with blackened, seared skinmargins
Stellate shaped wound, due to tearing of skinfrom expanding gas dissecting between thescalp and skull
Round wound with muzzle imprint, also due togas expanding under the skin causing it to pressback against the gun
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Near contact: muzzle of the gun is held a short
distance from the skin (< 1 cm from skin with handguns)
- Appears as circular wound with blackened and searededges that are wider than seen with contact wounds
Intermediate: defined by the presence of stippling
(powder tattooing) on the skin surrounding the entry
wound
- Stippling is due to unburned powder grains
exiting from the gun causing pinpoint abrasions on the
skin; these are not burns
- Actual distance from skin varies according to thegun; generally from a few centimeters up to several feet
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Distant: any distance beyond that which producesstippling
- Appear as round wounds with sharpmargins and an abrasion ring on the surrounding skin
Centerfire rifle wounds:
In contact wounds of the head with centerfire rifles,there is massive tissue destruction of the skin, skull,
and brain
Full metal jacketed bullets produce less tissuedamage and tend to travel through the bodyundeformed
Semi-jacketed ammunition creates the classic leadsnowstorm appearance on x-ray due to peeling backof the jacket as it travels through the body, releasingnumerous small lead fragments
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Shotgun wounds:
Shotgun bullets contain numerous pellets
At contact range up to a few feet, the entrancewound is a single round defect
At a range of 3-4 feet, the pellets begin to spreadout before reaching the body, producing one largeentry wound surrounded by scalloping or severalsmaller defects due to penetration by individualpellets
As the range increases, the central defect becomessmaller and the number of surrounding pellet holesincreases
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Exit wounds:
Usually more irregular in shape than entry wounds
Do not show soot deposition, muzzle imprint,
stippling, or blackening of the skin edges
A shored exit wound is one in which the skin is in
contact with another object when the bullet exits; this
causes an irregular area of abrasion on the skin,
which can be confused with the abrasion ring of anentrance wound
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Gunshot wounds in bone:
In flat bones (i.e. skull), entrance wounds are round with sharpmargins and show internal beveling: the inner table of the skull is
more eroded than the outer table, producing a cone shape in
the direction of the bullet path
Fragments of bone travel in the direction of the bullet paththrough the cranial vault
Exit wounds may be more irregular and show external
beveling (outer table of the skull is more eroded than the inner
table, producing a cone shape facing outward)
In the skull, gunshot wounds often produce numerous
fractures due to rapidly increasing pressure as the bullet travels
through the skull
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Characteristics of the Wound Entrance and Exit
Entrance Exit
Size Smaller than the
missile
Larger than the
missile
Edge Inverted Averted
Shape Round or oval No definite shape
Contusion Collar Present Absent
Gunpowder
Tattooing
Present in contact
or near contactfire
Absent
Paraffin test Positive Negative