Late nineteenth century introduced a new phenomenon, a higher velocity of injury. The resulting wounds caused extensive hard and soft tissue injuries. At the start of war, extremity injury were treated exclusively by ligation and amputation as advocated by Ambroise Pare. By the end of the war, major arterial reconstruction were performed in an attempt to save the limb. During the Korean War, the use of the autologous saphenous vein interpositional graft was introduced for greater adaptability in major arterial reconstruction 6.
Shotguns have low muzzle velocities, low chamber pressures and short range.
Classification of Gunshot Wounds Penetrating Perforating Avulsive High Velocity Wounds Low Velocity Wounds 11. Missile is retained in tissue Entry wound is typically small and ragged 12. Missiles pass completely through the target Entry wound is comparable to size of missile Exit wound is often considerably larger 13. Small entrance comparable to missile size Exit wound is usually gaping with large amount of tissue loss 14. Low Velocity Wounds Handguns, shotguns, most missile fragments Velocities below 2000 ft per sec slight predilection for the mandible vs. maxilia Energy of 300-500 joules 15.