Wound Ballistics

Norman A. Marcus, MD; William F. Blair, MD
JAMA. 1988;260(22):3278. doi:10.1001/jama.1988.03410220061023.
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To the Editor.—  In his timely but abstruse review of wound ballistics, Dr Fackler1 casts aspersions on certain clinical data by soundly criticizing them as "violation(s) of fundamental scientific method."An article with a purported scientific background should not resort to anecdotal comments to make a point. Our study2 demonstrated conclusively that most civilian gunshot wounds to the extremities that were extra-articular and not involving neurovascular compromise could, in fact, be safely managed by simple wound excision and cleansing. We do not support neglecting a contaminated wound, as Dr Fackler implies.Clinicians need not acquire "ballistics expertise" to treat gunshot wounds correctly. It must be recognized that inspection of the wound and an analysis of the history of the injury are mandatory to arrive at the appropriate treatment. There is both consensus and good data to support this point.


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