The analysis and shooting reconstruction of the ricocheted shotgun pellet wounds.

BACKGROUND: In this study, a 35 years old man was killed with the ricocheted shotgun pellets wounds from the asphalt road surface. The Public Prosecutor to define the ricochet point requested the ricocheted pellet pattern examination in two different ricochet distances. METHODS: The ten ricochet tests were performed for at 2 meters (point A) and 1 meter (point B) from the target, and the pellet distribution and pattern area were calculated using the gauss method. Then, the test and autopsy results were compared in the pellet number, calculated pellet pattern area and ricocheted angle. Furthermore, the similarity of the pellet number and the pellet pattern areas were examined using the two-tailed Mann-Whitney U test. RESULTS: In this study, 81 pellets recovered from the victim's body and the distribution pattern of pellets area was 2134 cm2. At the ricochet point A, the average number of pellets on the target was 82.1 and the distribution pattern of pellets area was 2700 cm2. At the ricochet point B, the average number of pellets on the target was 132.6 and the distribution pattern of pellets area was 4928 cm2. According to the two-tailed Mann-Whitney U test, there was low-level similarity (p<0.05 level Sig. 0.023; z=-2.424) on the pellet pattern area between autopsy and the ricochet point A. However, as regards the pellet number on the target, there was a similarity (p<0.05 level Sig. 0.481; z=-0.808) between autopsy and the ricochet point A. CONCLUSION: Test results showed that the pellet ricochet occurred two meters from the victim.

Use of self-expanding covered stent and negative pressure wound therapy to manage late rectal perforation after injury from an improvised explosive device: a case report.

Blast injuries, caused by explosions accompanied by high-pressure waves, produce tissue damage in the acute period, followed in the later period by circulatory disorders due to vascular endothelial damage and related tissue necrosis. Blunt rectal perforation is rare and difficult to diagnose. In the acute period following blast pelvic injuries, the main objectives are to stop bleeding, minimise contamination and preserve the patient's life. The patient in this report had major vascular injuries, severe pelvic injury and, in the later period, rectal perforation because of vascular endothelial damage caused by the blast effect. Our aim was to treat the patient conservatively because of his poor general condition. We placed a self-expanding covered stent (SECS) into the rectum and then applied negative pressure wound therapy (NPWT; V.A.C.® Therapy, KCI) to the pelvic region and perirectal area. At the end of the treatment, the rectal perforation was closed, and the patient was discharged with healing. In this article, we discuss the novel use of an SECS with NPWT and review related literature.

[The relationship between Injury Severity Scores and transfusion requirements of 108 consecutive cases injured with high kinetic energy weapons: a tertiary center end-mode mortality analysis]. / Yüksek kinetik enerjili silahlarla yaralanmis ardisik 108 olguya ait ISS degerleri ile transfüzyon gereksinimleri arasindaki iliski ve ileri merkez son mod mortalite analizi.

BACKGROUND: We aimed in this study to investigate the relationship between Injury Severity Score (ISS) and transfusion strategies required during medical intervention in patients wounded by high kinetic energy (HKE) gunshot, and to analyze end-mode mortality. METHODS: The medical data of patients were included in the study. We evaluated whether there was any significant correlation in terms of demographic characteristics, HKE weapon type, ISSs, and transfusion strategy options and transfusion requirements. RESULTS: Causes of mortality in cases resulting in mortality during hospitalization were evaluated. One hundred and eight consecutive patients were included in the study. All patients except one were male, with an average age of 25 years. 64.8% of them were injured by long-barreled firearms, whereas 35.2% were injured by explosives. Average ISS was 13.9. ISS values for the patients with and without transfusion were 16 (5-48) and 9 (3-36), respectively. Causes of mortality were evaluated in terms of systemic inflammatory response syndrome (SIRS), sepsis, and multiorgan dysfunction syndrome (MODS). DISCUSSION: It was determined that there was a significant correlation between increase in ISS values in cases with HKE weapon wounds and their transfusion requirements, whereas this requirement was independent of the ISS value in cases with explosive wounds.

[The wounding potential of free-falling bullets]. / Serbest Düsme Hareketi Yapan Mermi Çekirdeklerinin Yaralama Potansiyelleri.

BACKGROUND: It was aimed in this study to clarify the wounding potential of free-falling bullets fired at 90° or close to right angles. MEHTOHDS: In this study, 9x19 mm and 7.65x17 mm bullets, which are commonly used among civilians, were used. The muzzle velocities of these ammunitions were measured. According to the muzzle velocity data, the free-falling motion and strike velocity of the 9x19 mm and 7.65x17 mm bullets were simulated using the EBV4® External Ballistics Software at angles of 65°-90° with firings at 5° intervals. The simulation results were compared with critical velocity of tissues. In addition, the judicial records and press reports on this type of wound were examined and evaluated in light of the literature. RESULTS: The strike velocity and kinetic energy of free-falling bullets, which were fired into the air at 5° intervals between 65°-90°, were measured. The average strike velocity and kinetic energy of 9x19 mm bullets were 92.25 m/sec and 34.05 J and of 7.65x17 mm bullets were 79.66 m/sec and 14.91 J, respectively. As a result of the archives examination, 65 such wounds were detected between 2000 and 2012, and 27 of them resulted in death. DISCUSSION: According to these results, the strike velocity of free-falling 9x19 mm and 7.65x17 mm bullets, which were fired into the air, exceeds the threshold and critical velocity limits of skin and flat bones, and the kinetic energy of the bullets is able to cause significant wounding. Even though the symptoms and features of these types of wounds may not be similar to those of ordinary gunshot wounds in the first medical examination, the first responders should be aware of the possibility of gunshot wounds, and they should take into account the criminal investigation phase during the treatment process; the necessary precautions should be taken in order to preserve the evidence.

The performance of BALISTIKA 2010 system for 9 mm × 19 mm and 7.65 mm × 17 mm cartridge case correlation.

The firearm identification has two examination phases; the first phase is "one by one" cartridge case or bullet identification. The second phase is "Open Case File (OCF)" examination. Due to the size of the OCF archive, the OCF examination with only comparison microscopes takes a long time and is an unfeasible process. The Computerized Ballistic Identification Systems (CBIS) has become an essential tool for archive examination by correlation and preliminary eliminations. In this study, two objectives were pursued; the first is measuring the performance of the BALISTIKA 2010 system on cartridge case acquisition of handguns, correlation and examination. The second objective is the examination of the performance on the correlation according to brand and models of firearms. Detailed experimental results are demonstrated for about 2000 cartridge cases.

[The disguised face of blast injuries: shock waves]. / Patlama yaralanmalarinin gizli yüzü: Sok dalgalari.

BACKGROUND: The increase in terrorist attacks has brought a profound and new knowledge of blast injuries. In order to improve our knowledge regarding the mechanisms of blast injuries, we analyzed the effects of shock waves. METHODS: 100 g TNT and 1000 g C4 were detonated and recorded by high-speed camera. Blast wind, shock wave and shrapnel speeds were calculated, and final condition of the target was examined. RESULTS: A flash ball appeared first followed by the shock wave. Finally, blast wind occurred and shrapnel was distributed. The macroscopic structure of targets was not affected by the shock wave but was affected by shrapnel and blast wind. Shock waves created a transparent ballistic gel inside the target mat by changing its microscopic structure. The speed of the shock wave was 6482-7194 m/sn and shrapnel speed was 1420-1752 m/sn. CONCLUSION: Shock waves especially affect the air-filled organs and cause lung injury, acute respiratory distress syndrome, and intestinal and eardrum perforation. Blast wind destroys targets due to its high speed and high density. The main cause of mortality is shrapnel injury. The high temperature created by the explosion causes thermal injuries. Being informed of the mechanisms of blast injuries will assist in providing better treatment. Additionally, consideration of all mechanisms of blast injuries will facilitate lower mortality and morbidity rates.

Modified blank ammunition injuries.

Blank firing weapons are designed only for discharging blank ammunition cartridges. Because they are cost-effective, are easily accessible and can be modified to live firearms plus their unclear legal situation in Turkish Law makes them very popular in Turkey. 2004 through 2008, a total of 1115 modified blank weapons were seized in Turkey. Blank firing weapons are easily modified by owners, making them suitable for discharging live firearm ammunition or modified blank ammunitions. Two common methods are used for modification of blank weapons. After the modification, these weapons can discharge the live ammunition. However, due to compositional durability problems with these types of weapons; the main trend is to use the modified blank ammunitions rather than live firearm ammunition fired from modified blank firing weapons. In this study, two types of modified blank weapons and two types of modified blank cartridges were tested on three different target models. Each of the models' shooting side was coated with 1.3+/-2 mm thickness chrome tanned cowhide as a skin simulant. The first model was only coated with skin simulant. The second model was coated with skin simulant and 100% cotton police shirt. The third model was coated with skin simulant and jean denim. After the literature evaluation four high risky anatomic locations (the neck area; the eyes; the thorax area and inguinal area) were pointed out for the steel and lead projectiles are discharged from the modified blank weapons especially in close range (0-50 cm). The target models were designed for these anatomic locations. For the target models six Transparent Ballistic Candle blocks (TCB) were prepared and divided into two test groups. The first group tests were performed with lead projectiles and second group with steel projectile. The shortest penetration depth (lead projectile: 4.358 cm; steel projectile 8.032 cm) was recorded in the skin simulant and jean denim coated block for both groups. In both groups, the longest penetration depth (lead projectile: 6.434 cm; steel projectile 8.608 cm) was recorded in the only skin simulant coated block. And the penetration depth of skin simulant and 100% cotton police shirt coated model was 5.870 cm for lead projectile; 8.440 cm for steel projectile. According to penetration results, national and international legislations and production standards should be re-evaluated in order to prevent the modification of blank weapons and ammunitions. There are three methods for preventing modification of blank weapons: completely closed barrel structure; intersected restrain pieces application; eccentric barrel structure.

Organ models in wound ballistics: experimental study.

BACKGROUND: Effects of various types and diameters of guns and related treatment principles are different. Our study was performed to experimentally demonstrate the effects of different gunshots in body tissues. METHODS: 9x19 mm hand-gun and 7.62x51 mm G-3 infantry rifle were used in the study. Injury models were created through hand-gun and rifle shootings at isolated soft tissue, lower extremity, liver and intestine tissue simulants made of ballistic candle. High-speed cameras were used to capture 1000 frames per second. Images were examined and wound mechanisms were evaluated. RESULTS: It was observed that the colon content distributed more within the surrounding tissues by the rifle shootings comparing with hand-gun shootings and could be an infection source due to the large size of the cavity in the colon. Especially when the bullets hitting the bone were investigated, it was seen that much more tissue injury occurs with high speed bullets due to bullet deformation and fragmentation. However, no significant difference was found between the effect of hand-gun and rifle bullets passing through the extremity without hitting the bone. CONCLUSION: To know the type of the gun that caused the injury and its characteristics will allow to estimate severity and size of the injury before the treatment and to focus on different alternatives of treatment. Therefore, use of appropriate models is required in experimental studies.

[Comparison of soft tissue and bone injuries caused by handgun or rifle bullets: an experimental study]. / Tabanca ve piyade tüfegi mermileri ile olusturulan yumusak doku ve kemik yaralanmalarinin karsilastirilmasi: deneysel çalisma.

OBJECTIVES: The aim of this study was to investigate the factors that influence the severity of soft tissue and bone injuries occurring in gunshot traumas and to compare the effects of handgun and rifle bullets on these injuries. METHODS: Sixteen tissue simulants which were made of transparent gel candle blocks and calibrated to muscle tissue were targetted by pistol (9 mm parabellum) or military rifle (G-3) bullets. Half of the blocks contained fresh calf humerus bone. The effects of the bullets in tissue simulants were monitored by using high velocity cameras capable of taking 1,000 views per second. RESULTS: On a millisecond time scale, handgun bullets produced a small-sized temporary cavity while rifle bullets produced a wide temporary cavity in isolated soft tissue simulants. It was shown that the differences in the size of temporary cavities resulting from the blast effect correlated highly with the severity of injury occurring in soft tissues. In samples at which calf humerus bone was targetted, we observed that fragmentation and cavity effects correlated highly with the velocity of the bullet and determined the severity of injury. CONCLUSION: Experimental demonstration of differences in the size and severity of injuries caused by handgun or rifle bullets may have significant implications in the planning of treatment.

A new ballistic simulant "transparent gel candle" (experimental study).

BACKGROUND: Inanimate tissue stimulants have been used to show the bullet effects in ballistic studies. Gelatin has been being used as a ballistic stimulant for the last 20 years. It was considered that transparent gel candle (kraton in white paraffin oil) might be used as a soft tissue stimulant that can be an alternative for gelatin. METHODS: For calibration of transplant gel candle, firstly it was shot at the 10% ordinance gelatin at 4 o C, and several concentrations of the transparent gel candle at 4 o C, by later on, by using a competition air gun. It was seen that 15% kraton in 85% white paraffin oil is the most suitable concentration. This kind of transparent gel candle blocks tested by using 9 mm parabellum and 7.62 mm x 51 (NATO 7.62) infantry rifle bullets and high-speed camera. RESULTS: Because of its transparency and elasticity, the penetration, permanent and temporary cavities of bullets were observed clearly in transparent gel candle. CONCLUSIONS: As a result, transparent gel candle is a good soft tissue stimulant that it can be used in wound ballistic studies.

The magazine: a major cause of bullet fragmentation.

The fragmentation impact of high-velocity bullets penetrating the body after piercing through the magazines carried by soldiers was investigated experimentally. In this study, 16 pigs and 7.62x51-mm full metal jacket bullets were used. Pigs were assigned into two groups, and within 5 minutes of their being sacrificed with overdose anesthesia, bullets were fired into the first group on which magazines were placed and into the second group on which magazines were not placed, targeting abdominal left lower quadrant. It was found that in pigs not carrying magazines, all bullets pierced through the pig; bullets were not fragmented. However, in pigs with magazines, common fragmentation in bullets and multiple organ perforations occurred. It was concluded that magazines caused the bullets to be fragmented, increasing tissue and organ damage.