[Gunshot wounds--ballistics, physiopathology, surgical treatment]

The form and size of gunshot wounds depend on the projectile type (bird shot, deforming projectiles, non-deforming projectiles), its velocity at impact (high or low velocity projectiles) and the type of tissue affected by the projectile (soft tissues, bones). Gunshot wounds are always contaminated. While low velocity projectiles usually cause minimal wounds, high velocity projectiles can cause large, devastating wounds. All projectiles fired from firearms have a high velocity on impact and may cause death by traumatic shock instantaneously. Ballistics, pathophysiology and clinical findings of gunshot wounds are discussed, forensic aspects are mentioned. Gunshot wounds are often emergencies. Lifesaving and -stabilizing treatment is most important. A treatment plan aiming at preventing possible complications such as infections and functional disturbances is given for different types of gunshot wounds. Systemic lead poisoning has not been investigated sufficiently. Projectiles usually become encapsulated. The search for projectiles is associated with an additional surgical trauma and usually indicated only for joint wounds (lead arthropathy).