When bullets produce tracks in dense tissues, such as muscle, liver, spleen and blood, the tissues are compressed ahead of the track by a compression wave, in the form of a shock wave of spherical form.
· Tissue damage can also be produced at a considerable distance away from the original bullet track. Thus, the urinary bladder, stomach and colon may be ruptured in high velocity wounds situated at a remote distance from the abdominal cavity itself. Intermediate tissue damage.
· After a high velocity missile wound has been inflicted on the tissues, several zones of tissue damage can be identified. The site of the permanent local track is marked by tissues which have been totally destroyed, and this is similar to low-velocity bullets. Surrounding this is a layer of necrotic debris caused by the temporary cavitations effect and secondary missiles, highly contaminated by micro-organisms.
A variable thickness layer of live tissue surrounds the zone of necrosis, consisting of an inner portion which will prove to be non-viable as a result of the injuries sustained, and an outer portion that will remain viable provided that optimum conditions are provided for healing. Around this zone is normal tissue.
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