[The impossible compromise. Apropos of a paper on ballistic injuries by Messrs. Cooper and Ryan].
This paper analyzes a publication of wound ballistic from MM. Cooper and Ryan published in British Journal of Surgery 1990, vol. 77 June pp. 606-610 which call "Interaction of penetrating missiles with tissues: some common misapprehensions and implications for wound management". MM. Cooper and Ryan describe interaction of penetrating missiles with tissues, they denounce that they call common misapprehensions in wound ballistic and they try to reconcile engineers works and clinical observations. As a result of this synthesis, a management of war injuries is recommended. Authors of this present paper do a methodical analysis of the British publication and denounce: 1. the experimental method and the "energy-transfer" concept; 2. two contradictories and irreconcilable doctrines promulgated in wound ballistic world which are in one hand supporters of 5.56 bullets shock wave giving distant wounds and iatrogenic mutilations, on the other hand, supporter of wounds treatment without any need to know the weapon; 3. differences between wounds of war and peacetime is sometime more theoretical than real and may give the place to the concept of circumstances surgery.
Jourdan
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Neurochirurgien des Hôpitaux des Armées, H.I.A., Toulon Naval.
Vicq
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D001158:Arteries / Q000293:injuries; D001424:Bacterial Infections / Q000188:drug therapy / Q000209:etiology; D005389:Firearms; D006801:Humans; D007422:Intestines / Q000293:injuries; D014946:Wound Infection / Q000382:microbiology; D014948:Wounds, Gunshot / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D014950:Wounds, Penetrating / Q000150:complications / Q000382:microbiology / Q000628:therapy