Exit wounds are caused when a fast-moving object enters the body and exits in another location. They are usually larger and messier than entry wounds and require special care to prevent excessive blood loss and infection. Forensic specialists can determine the type of gun and bullet used based on entry and exit wounds. Care for exit wounds must also maintain the integrity of evidence.
Exit wounds are wounds caused when a bullet exits the body. The term typically refers to puncture wounds made from gunshot wounds, but can refer to any wound made by a fast-moving object forcibly entering the body in one location and exiting in another. Exit wounds are usually larger and more bumpy than entry wounds and typically require special care.
When a fast-moving projectile, such as a bullet, enters the body, it does so at an uninterrupted rate. The force of the bullet strikes the flesh, leaving a relatively clean, well-rounded wound. As the bullet travels through the body, however, it encounters resistance from organs and other internal structures. This causes it to slow down and adds to the overall amount of damage. With less force behind it, the bullet has to work harder to exit the body, resulting in messier and less regular exit wounds.
Exit wounds differ depending on the type of penetrating object. Some bullets cause more damage than others, and in some cases the exit wound can actually be smaller and cleaner than the entry wound. This most often occurs when the gun is fired very close to the body. Forensic specialists can often determine the type of gun and bullet used based on entry and exit wounds.
Caring for exit wounds is similar to caring for any major wound. The first concern of the medical team is to prevent excessive blood loss. Rapidly losing a large amount of blood can send the victim into shock and make it difficult to replace the fluid fast enough to prevent death. Once the bleeding has been controlled and vital organs have been evaluated and, if possible, repaired, the team can focus on cleaning and repairing the wound.
Infection is a major concern when caring for exit wounds, as the risk of infection increases when foreign bodies pass through the body. A larger wound may also be more likely to become contaminated than a smaller wound. Infection control begins with cleaning the area around the wound and closing the wound opening with stitches. In some cases, it may be necessary to pat the wound with sterile gauze to help it heal from the inside out.
Unlike accidental wounds, entry and exit wounds caused by bullets require meticulous care in maintaining the integrity of the evidence. Doctors and nurses may be required to photograph wounds or retain bullet pieces recovered from the body. While assistance in gathering evidence should never come at the expense of the best possible patient care, it is still an important aspect of caring for victims of gunshot wounds.
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