Doctors working in the accident and emergency department are increasingly faced with patients presenting with firearm injuries in the UK.

It is essential that a detailed description of the initial appearances of such wounds are made prior to surgical intervention, where the wounds may be completely removed or otherwise distorted. Of additional importance is the recovery of bullets or other projectiles from the wound.

Types of Firearm

Smooth Bore Weapons

These normally fire multiple projectiles, such as lead shot. Examples of such wounds are 12 bore and .410 shotguns. 12 bore shotguns are often 'double barreled'.Ammunition consists of a cartridge with a plastic or cardboard tube and a brass base (containing the percussion cap). Inside the cartridge there is a 'wad' of paper and cardboard, with a mass of lead pellets. All of these components may contribute to the wound characteristics, and can be useful in interpreting the direction of, and range of shot.

Rifled Weapons

Single missiles are fired through a barrel possessing a shallow spiral pattern, giving the bullet it's spin. The spiral pattern is composed of 'lands' and 'grooves' which leave a characteristic pattern on the bullet, and can be used in the comparison of bullets fired from a suspected weapon recovered at a later stage by the investigating authorities.

Examples are the revolver (where bullets are brought into position via a rotating cylinder), the automatic pistol (a self-loading weapon, where shells are put into firing position by a gas operated delivery system) and the rifle (a long barreled sporting or military weapon, commonly the .22 sporting rifle in the UK).

Close Contact Gunshot Wound

 illustrating a pattererned abrasion around the wound in the shape of the gun muzzle.

Contact Gunshot Wound - the barrel has contacted the skin, and the gases released have passed into the subcutaneous tissues, causing the stellate shaped laceration. There is also some grey/black discolouration and a faint abrasion ring.

Close Contact Gunshot Wound - .380  close range wound with powder burns.

Close Range (1 ft) Gunshot Wound - .357 wound with powder tatooing and blast damage from expanding gases (extensive lacerations).         

Intermediate Gunshot Wound - powder tatooing

Exit Wound - slit-like exit wound. No powder or soot.Could be mixed up with a stab wound.

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