Abstract
With no two gunshot wounds (GSW) being the same, novel research into wound ballistics is challenging. It is evident that the majority of previous wound ballistic research has been conducted without the presence of clothing. Whilst the effect of clothing on wound contamination has been explored, there is a paucity of literature examining the effect of clothing on GSW patterns. The aim of this study was to test the effect of Multi-Terrain Pattern (MTP) UK military clothing on GSW patterns within calibrated blocks of 10% by mass gelatine, using two types of ammunition commonly used in recent conflicts—7.62 × 39 mm and 5.45 × 39 mm. In total, 36 blocks were shot, 18 by each projectile type, further divided into 6 with no clothing layers (Cnil), 6 with a single clothing layer (Cmin) and 6 with maximum clothing layers (Cmax) worn on active duty. Blocks were analysed with high-speed video and dissection to capture measurements of damage, and results compared using analysis of variance (ANOVA). Results showed significantly different damage measurements within blocks with Cmax for both ammunition types compared to the other clothing states. This may result in GSWs that require more extensive surgical management, inviting further study.
Highlights
During the recent Iraq and Afghanistan wars (2003–2014), the UK military suffered 723 gunshot wound (GSW) casualties with 177 fatalities and 546 survivors leading to a substantial clinical burden [1]
Both projectiles were jacketed in steel with copper washes and the lead core of the 7.62 mm projectile was softer than the steel core of the 5.45 mm projectile which had a soft lead tip
That the temporary cavity height was smaller where 5.45 mm projectiles are used with Cmax does not matter, because the damage still occurred earlier within the wound tract and was still greater than that seen within the neck length which exists at the same position in blocks with Cmin and Cnil (Fig. 7 and Table 3)
Summary
During the recent Iraq and Afghanistan wars (2003–2014), the UK military suffered 723 gunshot wound (GSW) casualties with 177 fatalities and 546 survivors leading to a substantial clinical burden [1]. Historical review has demonstrated that clinical lessons learned from previous conflicts are often lost, leading to potentially avoidable higher morbidity amongst casualties [2, 3]. Undertaken using appropriate methods to continually test existing theory and research conducted over the last century, and help develop novel strategies to further understand wound ballistics. This may improve patient outcomes [4], and retain corporate knowledge gained previously and pass it on to the generation of clinicians. Whilst the effects of clothing on GSW have been examined with respect to contamination [e.g. 17–21], there remains a paucity of literature examining the effect of clothing on the wounding patterns; exceptions include separate works by Kieser, Carr, Mabbott and Mahoney [22,23,24,25]
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