It is apparent from review of published papers and books that misunderstanding and
confusion exists in the minds of many authors describing the interaction of penetrating missiles with tissues. These misapprehensions may influence the management of
wounds by suggesting didactic approaches based upon a preconceived notion of the nature and severity of the
wound for different types of projectiles. This review considers the biophysics of penetrating missile
wounds, highlights some of the more common misconceptions and seeks to reconcile the conflicting and confusing management doctrines that are promulgated in the literature-differences that arise not only from two scenarios, peace and war, but also from misapprehensions of the wounding process.
Wounds of war and of peacetime differ both in the nature of the
wound and in the propensity for
wound infection. Additionally, the limitations imposed by war dictate the type of management that may be practised and result in procedures that would be considered inappropriate by some in civilian clinical practice. Many of the procedures described in civilian peacetime settings, such as reliance on
antibiotics alone for the control of
infection in
penetrating wounds, or minimal excision and
debridement, can yield good results but would herald disaster if transposed to a war setting.