![]() ![]() High-velocity penetration: Examples include injuries caused by bullets or shell fragments, from direct trauma or shockwave injury to surrounding brain tissue due to a stretch injury.Penetrating head injury also called penetrating brain injury is a wound in which a projectile breaches the cranium but does not exit it 9.īased on the speed of penetration, penetrating head injury can be classified into two categories: If enough energy is transferred, the liver may disintegrate 7. Flexible elastic soft tissues, such as muscle, intestine, skin, and blood vessels, are good energy absorbers and are resistant to tissue stretch. Skin, muscles, and intestines absorb energy and so are resistant to the development of temporary cavitation, while organs such as the liver, spleen, kidney, and brain, which have relatively low tensile strength, are likely to split or shatter because of temporary cavitation 8. The characteristics of the damaged tissue determine the severity of the injury: the denser the tissue, the greater the amount of energy transmitted to it. The temporary cavity is the radial stretching of tissue around the bullet’s wound track, which momentarily leaves an empty space caused by high pressures surrounding the projectile that accelerate material away from its path 7. ![]() The tissues move back into place, eliminating the cavity, but the cavitation has already done considerable damage. In addition to damage to the tissues they contact, medium- and high-velocity projectiles result in a secondary cavitation injury as the object enters the body, it creates a pressure wave forcing tissue out of the way, creating a cavity or “temporary cavitation” 6. The space left by tissue that is destroyed by the penetrating object forms a cavity, and this is called permanent cavitation. Kinetic energy is described by the following equation: Kinetic energy = ½mv 2 OR 1/2 mass X velocity (squared).Kinetic energy increases with the square of the velocity. The velocity of the projectile is a more important factor than its mass in determining how much damage is done 3. Increased velocity causes more damage than mass. Penetrating trauma causesĪs a projectile passes through tissue, it decelerates and transfers kinetic energy to the tissue. Injuries are the leading cause of death in patients aged 1-44 years 5. In some areas of the United States, approximately 90% of patients with penetrating trauma are male. Males constitute the great majority of patients with penetrating trauma injuries across the United States and the world. Management usually involves supportive measures (hemostasis, blood transfusion, respiratory support), and surgical repair of damaged structures and/or removal of foreign bodies. Penetrating trauma signs and symptoms vary widely depending on the injured parts of the body and the shape and size of the penetrating object and the amount of energy transmitted to the tissues 2.ĭiagnosis is established based on history and imaging studies (X-rays, CT/MRI scans). Penetrating trauma can be serious because it can damage internal organs and presents a risk of shock and infection. This type of trauma is seen in a stabbing or a gunshot wound in which a low-velocity pistol bullet was used.A puncture is different from a penetration wound in that there is no exit wound in a puncture.Treatment involves surgery to repair damaged structures and remove foreign objects. Assessment includes x-rays, CT scans, and MRI. The severity depends on the body organs involved, the characteristics of the object, and the amount of energy transmitted. Penetrating trauma often causes damage to internal organs resulting in shock and infection. Penetrating trauma can be caused by violence and may result from: Penetrating trauma suggests the object does not pass through. Perforating trauma is associated with an entrance wound and an often larger exit wound. An injury in which an object enters the body or a structure and passes all the way through is called a perforating injury, while penetrating trauma implies that the object does not pass through 4. The penetrating object may remain in the tissues, come back out the way it entered, or pass through the tissues and exit from another area 3. The most common causes of penetrating trauma are gunshots and stab wounds 2. Penetrating injury is usually the result of the abrupt, direct application of a mechanical force to a focal area 1. Penetrating trauma is an injury that occurs when a foreign object pierces the skin and enters a tissue of the body which could damage the underlying tissues or organs, creating an open wound. The severity of the internal injury depends on the organ(s) penetrated and on how vital the organ is. Penetrating abdominal trauma prognosis Penetrating trauma
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