High velocity missile injury

Amato, Joseph J.; Billy, Lawrence J.; Lawson, Noel S.; Rich, Norman M.

doi:10.1016/0002-9610(74)90296-7

Cited by 71 publications

(6 citation statements)

References 4 publications

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“…This implies that low-energy projectiles do not significantly damage the surrounding tissue beyond the projectile's immediate path. 29 The unsuccessful surgical outcomes in nines patients with injuries from high-energy projectiles may be related to the remote effects of temporary cavitation. These remote effects may include cellular and subcellular damage of tissue surrounding the resected or anastomotic region, leading to further complications.…”

Section: Discussionmentioning

confidence: 99%

Performance of primary repair on colon injuries sustained from low-versus high-energy projectiles

Lazovic

Radojević

Curovic

2016

Journal of Forensic and Legal Medicine

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Among various reasons, colon injuries may be caused by low- or high-energy firearm bullets, with the latter producing a temporary cavitation phenomenon. The available treatment options include primary repair and two-stage management, but recent studies have shown that primary repair can be widely used with a high success rate. This paper investigates the differences in performance of primary repair on these two types of colon injuries. Two groups of patients who sustained colon injuries due to single gunshot wounds, were retrospectively categorized based on the type of bullet. Primary colon repair was performed in all patients selected based on the inclusion and exclusion criteria (Stone and Fabian's criteria). An almost absolute homogeneity was attained among the groups in terms of age, latent time before surgery, and four trauma indexes. Only one patient from the low-energy firearm projectile group (4%) developed a postsurgical complication versus nine patients (25.8%) from the high-energy group, showing statistically significant difference (p = 0.03). These nine patients experienced the following postsurgical complications: pneumonia, abscess, fistula, suture leakage, and one multiorgan failure with sepsis. Previous studies concluded that one-stage primary repair is the best treatment option for colon injuries. However, terminal ballistics testing determined the projectile's path through the body and revealed that low-energy projectiles caused considerably lesser damage than their high-energy counterparts. Primary colon repair must be performed definitely for low-energy short firearm injuries but very carefully for high-energy injuries. Given these findings, we suggest that the treatment option should be determined based not only on the bullet type alone but also on other clinical findings.

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Section: Discussionmentioning

confidence: 99%

Performance of primary repair on colon injuries sustained from low-versus high-energy projectiles

Lazovic

Radojević

Curovic

2016

Journal of Forensic and Legal Medicine

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“…Tumbling of a high-velocity projectile increases tissue destruction and may lead to fragmentation of the bullet. Tissue destruction is greatest when the entire kinetic energy of the projectile is absorbed compared with a projectile that passes through and through the tissues [2,3,6,9].…”

Section: Velocitymentioning

confidence: 99%

Penetrating Injury in the Dog and Cat

Mehler¹

2015

Small Animal Surgical Emergencies

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“…Previous studies using flash x-ray radiography have indicated that high-velocity projectiles can, under some circumstances, cause cavitation extending well beyond the bullet trajectory in water, gelatin, and other human tissue surrogate materials. [13][14][15][16][17][18][19][20][21] While high-speed optical images of a bullet interacting with a human cadaver leg were published, 16 showing the surface of the leg, to our knowledge no flash x-ray images of the internal cavitation in human cadaver legs have been published.…”

Section: Flash X-ray Images Of Cavitationmentioning

confidence: 99%

Intense nanosecond duration source of 10–250 keV x rays suitable for imaging projectile-induced cavitation in human cadaver tissue

Boyer

Holland

Seely

2005

Review of Scientific Instruments

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The design, fabrication, and performance of a repetitive nanosecond x-ray source having a pumped field-emission x-ray tube are described. A compact Marx generator, 61 cm in length and storing 12 J energy, directly drives the field-emission tube with voltage pulses >380kV and with <4ns rise time from an equivalent generator impedance of 52Ω. The x-ray dose is 520 μSv at a distance of 30.5 cm. A numerical simulation model is used in which the x-ray tube’s cathode width and anode-cathode gap spacing are permitted to change with time, while electron flow between the cathode and anode is space charge limited and nonrelativistic. The x-ray tube model is coupled to an equivalent circuit representation of the Marx generator that includes the capacitance variation with charging voltage of the BaTiO3 capacitors. The capabilities of the x-ray source for flash radiography have been demonstrated by the study of the evolution of cavitation in human cadaver legs induced by high-velocity projectiles.

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High velocity missile injury

Cited by 71 publications

References 4 publications

Performance of primary repair on colon injuries sustained from low-versus high-energy projectiles

Performance of primary repair on colon injuries sustained from low-versus high-energy projectiles

Penetrating Injury in the Dog and Cat

Intense nanosecond duration source of 10–250 keV x rays suitable for imaging projectile-induced cavitation in human cadaver tissue

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