Terrorist attacks: cutaneous patterns of gunshot and secondary blast injuries

Abstract

Terrorist attacks have been on the rise. During the recent terrorist attacks in France, terrorists perpetrated their acts using weapons of war, as well as explosive charges. These two modes of action, when combined, can create skin lesions with similar macroscopic appearances, which can sometimes go unnoticed because of body fragmentation. A total of 68 autopsies, 83 external examinations, 140 standard radiographic examinations, and 49 computed tomography (CT) scans were performed over 7 days during the 2015 terrorist attacks in France. Bodies were injured by firearms and shrapnel-like projectiles. We analysed the clinical findings for the secondary blast cutaneous lesions from the explosive devices and compared these lesions with ballistic-related lesions to highlight that patterns can be macroscopically similar on external examination. Secondary blast injuries are characterised by penetrating trauma associated with materials added to explosive systems that are propelled by explosive air movement. These injuries are caused most often by small, shrapnel-like metallic objects, such as nails and bolts. Propulsion causes ballistic-type injuries that must be recognised and distinguished from those caused by firearm projectiles. Differentiating between these lesions is very difficult when using conventional criteria (size, shape, number and distribution on the body) with only external examination of corpses. This is why the particularities of these lesions must be further illustrated and then confirmed by complete autopsies and radiological and anatomopathological examinations. KEY POINTS When occurring simultaneously in terrorist attacks, injuries caused by secondary blasts appear as cutaneous wound patterns that can be macroscopically very similar to those caused by firearm projectiles. The criteria usually found in the literature for distinguishing these two types of projectiles may be difficult to use. It is important in these difficult situations to benefit from systematic postmortem imaging. Systematic autopsy and then anatomopathological analyses of the orifices also help determine the cause of the wounds.

Successful Reconstruction of a Lower Chest Wall Defect with Delayed Fungal Deep Sternal Wound Infection following a Blast Injury in South Korea: A Case Report

“…The effects of blast injuries are classified as primary, secondary, tertiary, and quaternary [4,6]. Primary injuries are caused by pressure waves, whereas secondary injuries are caused by fragments of explosive devices and stone or soil debris scattered by the detonation [3,4,6,7]. Tertiary injuries are the result of bodily displacement, and while quaternary injuries include burns, inhalation of toxins, and exposure to radiation [4,6].…”

“…Tertiary injuries are the result of bodily displacement, and while quaternary injuries include burns, inhalation of toxins, and exposure to radiation [4,6]. Since a pressure wave accelerates shrapnel contaminated with dirty soil debris in an uncontrolled direction, extensive pene- trating injuries through vital organs such as the heart and lungs can occur after an explosion [6][7][8]. Therefore, the first priority should be resuscitation of the patient with adequate management of the vital organs.…”

Interpol review of forensic firearm examination 2019–2022

“…The injuries of a multiple victim terrorist attack are described [ 178 ]. The victims had been shot with 7.62 × 39mm assault rifles and were exposed to explosions.…”

Forensic multidisciplinary involvement after terrorist attacks

“…The articles by Delannoy et al. [ 3 ] and Tracqui et al. [ 4 ] retrace the forensic investigations performed after the terrorist attacks in Paris on November 2015.…”

“…The paper of Delannoy et al. [ 3 ] is about the cutaneous patterns of gunshot and secondary blast injuries after the events actions, where terrorists used weapons of war as well as explosive charges. These two modes of action can, when combined, create skin lesions with similar macroscopic appearances, which can sometimes go unnoticed due to body fragmentation.…”