A civilian perspective on ballistic trauma and gunshot injuries. 2010

Philipp Lichte, and Reiner Oberbeck, and Marcel Binnebösel, and Rene Wildenauer, and Hans-Christoph Pape, and Philipp Kobbe
Department of Trauma Surgery, University Hospital of the RWTH Aachen, Aachen, Germany. plichte@ukaachen.de

BACKGROUND Gun violence is on the rise in some European countries, however most of the literature on gunshot injuries pertains to military weaponry and is difficult to apply to civilians, due to dissimilarities in wound contamination and wounding potential of firearms and ammunition. Gunshot injuries in civilians have more focal injury patterns and should be considered distinct entities. METHODS A search of the National Library of Medicine and the National Institutes of Health MEDLINE database was performed using PubMed. RESULTS Craniocerebral gunshot injuries are often lethal, especially after suicide attempts. The treatment of non space consuming haematomas and the indications for invasive pressure measurement are controversial. Civilian gunshot injuries to the torso mostly intend to kill; however for those patients who do not die at the scene and are hemodynamically stable, insertion of a chest tube is usually the only required procedure for the majority of penetrating chest injuries. In penetrating abdominal injuries there is a trend towards non-operative care, provided that the patient is hemodynamically stable. Spinal gunshots can also often be treated without operation. Gunshot injuries of the extremities are rarely life-threatening but can be associated with severe morbidity.With the exception of craniocerebral, bowel, articular, or severe soft tissue injury, the use of antibiotics is controversial and may depend on the surgeon's preference. CONCLUSIONS The treatment strategy for patients with gunshot injuries to the torso mostly depends on the hemodynamic status of the patient. Whereas hemodynamically unstable patients require immediate operative measures like thoracotomy or laparotomy, hemodynamically stable patients might be treated with minor surgical procedures (e.g. chest tube) or even conservatively.

UI MeSH Term Description Entries
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D005060 Europe The continent north of AFRICA, west of ASIA and east of the ATLANTIC OCEAN. Northern Europe,Southern Europe,Western Europe
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014948 Wounds, Gunshot Disruption of structural continuity of the body as a result of the discharge of firearms. Gunshot Wound,Gunshot Wounds,Wound, Gunshot
D044709 Forensic Ballistics The science of studying projectiles in motion, ballistics, being applied to law. Ballistics on firearm projectiles, such as bullets, include the study of what happens inside the weapon, during the flight of the projectile, and when the projectile strikes the target, such as body tissue. Ballistics,Ballistics, Wound,Ballistic, Forensic,Ballistics, Forensic,Forensic Ballistic,Wound Ballistics

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