A new model for the characterization of infection risk in gunshot injuries: technology, principal consideration and clinical implementation.
BACKGROUND
The extent of wound contamination in gunshot injuries is still a topic of controversial debate. The purpose of the present study is to develop a model that illustrates the contamination of wounds with exogenous particles along the bullet path.


METHODS
To simulate bacteria, radio-opaque barium titanate (3-6 μm in diameter) was atomized in a dust chamber. Full metal jacket or soft point bullets caliber .222 (n = 12, v0 = 1096 m/s) were fired through the chamber into a gelatin block directly behind it. After that, the gelatin block underwent multi-slice CT in order to analyze the permanent and temporary wound cavity.


RESULTS
The permanent cavity caused by both types of projectiles showed deposits of barium titanate distributed over the entire bullet path. Full metal jacket bullets left only few traces of barium titanate in the temporary cavity. In contrast, the soft point bullets disintegrated completely, and barium titanate covered the entire wound cavity.


CONCLUSIONS
Deep penetration of potential exogenous bacteria can be simulated easily and reproducibly with barium titanate particles shot into a gelatin block. Additionally, this procedure permits conclusions to be drawn about the distribution of possible contaminants and thus can yield essential findings in terms of necessary therapeutic procedures.
Department of Craniomaxillofacial Surgery, Hannover Medical School, Hannover, Germany.
Constantin
C
von See
Majeed
M
Rana
Marcus
M
Stoetzer
Conrad
C
Wilker
Martin
M
Rücker
Nils-Claudius
NC
Gellrich
D017609:Barium Compounds; D005389:Firearms; D005780:Gelatin; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008953:Models, Anatomic; D010781:Photography; D011859:Radiography; D014025:Titanium; D014946:Wound Infection / Q000000981:diagnostic imaging* / Q000382:microbiology*; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging* / Q000382:microbiology*
D017609:Barium Compounds; C024547:barium titanate(IV); D005780:Gelatin; D014025:Titanium