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href="https://be.wikipedia.org/wiki/%D0%9F%D1%80%D0%B0%D0%BD%D1%96%D0%BA%D0%B0%D0%BB%D1%8C%D0%BD%D0%B0%D1%8F_%D1%80%D0%B0%D0%BD%D0%B0" title="Пранікальная рана – Belarusian" lang="be" hreflang="be" data-title="Пранікальная рана" data-language-autonym="Беларуская" data-language-local-name="Belarusian" class="interlanguage-link-target"><span>Беларуская</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Traumatisme_penetrant" title="Traumatisme penetrant – Catalan" lang="ca" hreflang="ca" data-title="Traumatisme penetrant" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Traumatismo_penetrante" title="Traumatismo penetrante – Spanish" lang="es" hreflang="es" data-title="Traumatismo penetrante" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AA%D8%B1%D9%88%D9%85%D8%A7%DB%8C_%D9%86%D8%A7%D9%81%D8%B0" title="ترومای نافذ – Persian" lang="fa" hreflang="fa" data-title="ترومای نافذ" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Trauma_tajam" title="Trauma tajam – Indonesian" lang="id" hreflang="id" data-title="Trauma tajam" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-ms mw-list-item"><a href="https://ms.wikipedia.org/wiki/Trauma_tajam" title="Trauma tajam – Malay" lang="ms" hreflang="ms" data-title="Trauma tajam" 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<div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Type of injury</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"Exit wound" redirects here. For other uses, see <a href="/wiki/Exit_wound_(disambiguation)" class="mw-redirect mw-disambig" title="Exit wound (disambiguation)">Exit wound (disambiguation)</a>.</div> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Penetrating trauma</th></tr><tr><td colspan="2" class="infobox-full-data"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Shotgun_wound.JPG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/Shotgun_wound.JPG/220px-Shotgun_wound.JPG" decoding="async" width="220" height="115" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/2/26/Shotgun_wound.JPG/330px-Shotgun_wound.JPG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/2/26/Shotgun_wound.JPG/440px-Shotgun_wound.JPG 2x" data-file-width="3745" data-file-height="1957" /></a></span></td></tr><tr><td colspan="2" class="infobox-full-data">Acute penetrating trauma from a close-range <a href="/wiki/Shotgun" title="Shotgun">shotgun</a> <a href="/wiki/Blast_injury" title="Blast injury">blast injury</a> to knee. <a href="/wiki/Birdshot" class="mw-redirect" title="Birdshot">Birdshot pellets</a> are visible in the wound, within the shattered <a href="/wiki/Patella" title="Patella">patella</a>. The powder wad from the <a href="/wiki/Shotgun_shell" class="mw-redirect" title="Shotgun shell">shotgun shell</a> has been extracted from the wound, and is visible at the upper right of the image.</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Trauma_surgery" title="Trauma surgery">Trauma surgery</a>, <a href="/wiki/General_surgery" title="General surgery">General surgery</a>, <a href="/wiki/Emergency_medicine" title="Emergency medicine">emergency medicine</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}</style> <p><b>Penetrating trauma</b> is an <a href="/wiki/Open_wound" class="mw-redirect" title="Open wound">open wound</a> <a href="/wiki/Injury" title="Injury">injury</a> that occurs when an object pierces the <a href="/wiki/Human_skin" title="Human skin">skin</a> and enters a <a href="/wiki/Tissue_(biology)" title="Tissue (biology)">tissue</a> of the body, creating a deep but relatively narrow entry <a href="/wiki/Wound" title="Wound">wound</a>. In contrast, a <a href="/wiki/Blunt_trauma" title="Blunt trauma">blunt or <i>non-penetrating</i> trauma</a> may have some deep damage, but the overlying skin is not necessarily broken and the wound is still closed to the outside environment. The penetrating object may <a href="/wiki/Foreign_body" title="Foreign body">remain in the tissues</a>, come back out the path it entered, or pass through the full thickness of the tissues and exit from another area.<sup id="cite_ref-StewartPrin05_1-0" class="reference"><a href="#cite_note-StewartPrin05-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>A penetrating injury in which an object enters the body or a structure and passes all the way through an exit wound is called a <b>perforating trauma</b>, while the term <i>penetrating trauma</i> implies that the object does not perforate wholly through.<sup id="cite_ref-Blank06_2-0" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In <a href="/wiki/Gunshot_wound" title="Gunshot wound">gunshot wounds</a>, perforating trauma is associated with an entrance wound and an often larger exit wound. </p><p>Penetrating trauma can be caused by a foreign object or by fragments of a broken bone. Usually occurring in <a href="/wiki/Violent_crime" title="Violent crime">violent crime</a> or <a href="/wiki/Armed_combat" class="mw-redirect" title="Armed combat">armed combat</a>,<sup id="cite_ref-Enepekides05_3-0" class="reference"><a href="#cite_note-Enepekides05-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> penetrating injuries are commonly caused by <a href="/wiki/Ballistic_trauma" class="mw-redirect" title="Ballistic trauma">gunshots</a> and <a href="/wiki/Stabbing" title="Stabbing">stabbings</a>.<sup id="cite_ref-Gupton02_4-0" class="reference"><a href="#cite_note-Gupton02-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Penetrating trauma can be serious because it can damage internal organs and presents a risk of <a href="/wiki/Shock_(circulatory)" title="Shock (circulatory)">shock</a> and <a href="/wiki/Infection" title="Infection">infection</a>. The severity of the injury varies widely depending on the body parts involved, the characteristics of the penetrating object, and the amount of <a href="/wiki/Energy" title="Energy">energy</a> transmitted to the tissues.<sup id="cite_ref-Gupton02_4-1" class="reference"><a href="#cite_note-Gupton02-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Assessment may involve <a href="/wiki/X-ray" title="X-ray">X-rays</a> or <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">CT scans</a>, and treatment may involve surgery, for example to repair damaged structures or to remove foreign objects. Following penetrating trauma, <a href="/wiki/Spinal_motion_restriction" class="mw-redirect" title="Spinal motion restriction">spinal motion restriction</a> is associated with worse outcomes and therefore it should not be done routinely.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Mechanism">Mechanism</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=1" title="Edit section: Mechanism"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Further information: <a href="/wiki/Gunshot_wound" title="Gunshot wound">Gunshot wound</a> and <a href="/wiki/Stab_wound" title="Stab wound">Stab wound</a></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Chapter1figure1-Superficial_bullet_wound.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/8/86/Chapter1figure1-Superficial_bullet_wound.jpg/220px-Chapter1figure1-Superficial_bullet_wound.jpg" decoding="async" width="220" height="199" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/8/86/Chapter1figure1-Superficial_bullet_wound.jpg/330px-Chapter1figure1-Superficial_bullet_wound.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/8/86/Chapter1figure1-Superficial_bullet_wound.jpg/440px-Chapter1figure1-Superficial_bullet_wound.jpg 2x" data-file-width="500" data-file-height="452" /></a><figcaption>A superficial gunshot wound to the <a href="/wiki/Axilla" title="Axilla">armpit</a></figcaption></figure> <p>As a missile passes through tissue, it <a href="/wiki/Acceleration" title="Acceleration">decelerates</a>, dissipating and transferring <a href="/wiki/Kinetic_energy" title="Kinetic energy">kinetic energy</a> to the tissues.<sup id="cite_ref-StewartPrin05_1-1" class="reference"><a href="#cite_note-StewartPrin05-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> The <a href="/wiki/Velocity" title="Velocity">velocity</a> of the projectile is a more important factor than its mass in determining how much damage is done;<sup id="cite_ref-StewartPrin05_1-2" class="reference"><a href="#cite_note-StewartPrin05-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> kinetic energy increases with the square of the velocity. In addition to injury caused directly by the object that enters the body, penetrating injuries may be associated with secondary injuries, due for example to a <a href="/wiki/Blast_injury" title="Blast injury">blast injury</a>.<sup id="cite_ref-Blank06_2-1" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>The path of a projectile can be estimated by imagining a line from the entrance wound to the exit wound, but the actual trajectory may vary due to <a href="/wiki/Ricochet" title="Ricochet">ricochet</a> or differences in tissue density.<sup id="cite_ref-Gupton02_4-2" class="reference"><a href="#cite_note-Gupton02-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> In a cut, the discolouration and the swelling of the skin from a blow happens because of the ruptured blood vessels and escape of blood and fluid and other injuries that interrupt the circulation.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Cavitation">Cavitation</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=2" title="Edit section: Cavitation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading4"><h4 id="Permanent">Permanent</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=3" title="Edit section: Permanent"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Low-velocity items, such as knives and swords, are usually propelled by a person's hand, and usually do damage only to the area that is directly contacted by the object.<sup id="cite_ref-brady_7-0" class="reference"><a href="#cite_note-brady-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> The space left by tissue that is destroyed by the penetrating object as it passes through forms a cavity; this is called <b>permanent cavitation</b>.<sup id="cite_ref-DiGiacomo02_8-0" class="reference"><a href="#cite_note-DiGiacomo02-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Temporary">Temporary</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=4" title="Edit section: Temporary"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>High-velocity objects are usually <a href="/wiki/Projectile" title="Projectile">projectiles</a> such as <a href="/wiki/Bullet" title="Bullet">bullets</a> from high-powered rifles, such as <a href="/wiki/Assault_rifle" title="Assault rifle">assault rifles</a><sup id="cite_ref-brady_7-1" class="reference"><a href="#cite_note-brady-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> or <a href="/wiki/Sniper_rifle" title="Sniper rifle">sniper rifles</a>. Bullets classed as medium-velocity projectiles include those from <a href="/wiki/Handgun" title="Handgun">handguns</a>, <a href="/wiki/Shotgun" title="Shotgun">shotguns</a>,<sup id="cite_ref-brady_7-2" class="reference"><a href="#cite_note-brady-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/Submachine_gun" title="Submachine gun">submachine guns</a>. In addition to causing damage to the tissues they contact, medium- and high-velocity projectiles cause a secondary cavitation injury: as the object enters the body, it creates a <a href="/wiki/P-wave" class="mw-redirect" title="P-wave">pressure wave</a> which forces tissue out of the way, creating a cavity which can be much larger than the object itself; this is called "temporary cavitation".<sup id="cite_ref-DiGiacomo02_8-1" class="reference"><a href="#cite_note-DiGiacomo02-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> The temporary cavity is the radial stretching of tissue around the bullet's wound track, which momentarily leaves an empty space caused by high pressures surrounding the projectile that accelerate material away from its path.<sup id="cite_ref-maiden2009_9-0" class="reference"><a href="#cite_note-maiden2009-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>The characteristics of the tissue injured also help determine the severity of the injury; for example, the denser the tissue, the greater the amount of energy transmitted to it.<sup id="cite_ref-DiGiacomo02_8-2" class="reference"><a href="#cite_note-DiGiacomo02-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Skin, muscles, and intestines absorb energy and so are resistant to the development of temporary cavitation, while organs such as the liver, spleen, kidney, and brain, which have relatively low tensile strength, are likely to split or shatter because of temporary cavitation.<sup id="cite_ref-jtacs20160601_10-0" class="reference"><a href="#cite_note-jtacs20160601-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Flexible elastic soft tissues, such as muscle, intestine, skin, and blood vessels, are good energy absorbers and are resistant to tissue stretch. If enough energy is transferred, the liver may disintegrate.<sup id="cite_ref-maiden2009_9-1" class="reference"><a href="#cite_note-maiden2009-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> Temporary cavitation can be especially damaging when it affects delicate tissues such as the <a href="/wiki/Human_brain" title="Human brain">brain</a>, as occurs in penetrating head trauma.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (March 2018)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="Location">Location</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=5" title="Edit section: Location"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Head">Head</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=6" title="Edit section: Head"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main articles: <a href="/wiki/Penetrating_head_injury" title="Penetrating head injury">Penetrating head injury</a>, <a href="/wiki/Facial_trauma" title="Facial trauma">Facial trauma</a>, and <a href="/wiki/Eye_injury" title="Eye injury">Eye injury</a></div> <p>While <a href="/wiki/Penetrating_head_injury" title="Penetrating head injury">penetrating head trauma</a> accounts for only a small percentage of all <a href="/wiki/Traumatic_brain_injury" title="Traumatic brain injury">traumatic brain injuries</a> (TBI), it is associated with a high <a href="/wiki/Mortality_rate" title="Mortality rate">mortality rate</a>, and only a third of people with penetrating <a href="/wiki/Head_injury" title="Head injury">head trauma</a> survive long enough to arrive at a hospital. Injuries from firearms are the leading cause of TBI-related deaths. Penetrating head trauma can cause <a href="/wiki/Cerebral_contusion" title="Cerebral contusion">cerebral contusions</a> and lacerations, <a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">intracranial hematomas</a>, <a href="/wiki/Pseudoaneurysm" title="Pseudoaneurysm">pseudoaneurysms</a>, and <a href="/wiki/Arteriovenous_fistula" title="Arteriovenous fistula">arteriovenous fistulas</a>. The prognosis for penetrating head injuries varies widely.<sup id="cite_ref-Blissitt06_11-0" class="reference"><a href="#cite_note-Blissitt06-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>Penetrating <a href="/wiki/Facial_trauma" title="Facial trauma">facial trauma</a> can pose a risk to the <a href="/wiki/Airway" class="mw-redirect" title="Airway">airway</a> and <a href="/wiki/Breathing" title="Breathing">breathing</a>; airway obstruction can occur later due to <a href="/wiki/Edema" title="Edema">swelling</a> or bleeding.<sup id="cite_ref-Stewart05_12-0" class="reference"><a href="#cite_note-Stewart05-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Penetrating <a href="/wiki/Eye_injury" title="Eye injury">eye trauma</a> can cause the globe of the <a href="/wiki/Human_eye" title="Human eye">eye</a> to rupture or <a href="/wiki/Vitreous_humour" class="mw-redirect" title="Vitreous humour">vitreous humor</a> to leak from it, and presents a serious threat to eyesight.<sup id="cite_ref-Jenkins05_13-0" class="reference"><a href="#cite_note-Jenkins05-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Chest">Chest</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=7" title="Edit section: Chest"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Chest_trauma" class="mw-redirect" title="Chest trauma">Chest trauma</a></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Bullet_in_heart.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/0/07/Bullet_in_heart.jpg/220px-Bullet_in_heart.jpg" decoding="async" width="220" height="247" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/0/07/Bullet_in_heart.jpg 1.5x" data-file-width="259" data-file-height="291" /></a><figcaption>X-ray showing a bullet (white spot) in the heart</figcaption></figure> <p>Most penetrating injuries are chest wounds and have a mortality rate (death rate) of under 10%.<sup id="cite_ref-Prentice94_14-0" class="reference"><a href="#cite_note-Prentice94-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> Penetrating <a href="/wiki/Chest_trauma" class="mw-redirect" title="Chest trauma">chest trauma</a> can injure vital organs such as the heart and lungs and can interfere with breathing and circulation. Lung injuries that can be caused by penetrating trauma include <a href="/wiki/Pulmonary_laceration" title="Pulmonary laceration">pulmonary laceration</a> (a cut or tear) <a href="/wiki/Pulmonary_contusion" title="Pulmonary contusion">pulmonary contusion</a> (a bruise), <a href="/wiki/Hemothorax" title="Hemothorax">hemothorax</a> (an accumulation of blood in the chest cavity outside of the lung), <a href="/wiki/Pneumothorax" title="Pneumothorax">pneumothorax</a> (an accumulation of air in the chest cavity) and <a href="/wiki/Hemopneumothorax" title="Hemopneumothorax">hemopneumothorax</a> (accumulation of both blood and air). <a href="/wiki/Pneumothorax" title="Pneumothorax">Sucking chest wounds</a> and <a href="/wiki/Tension_pneumothorax" class="mw-redirect" title="Tension pneumothorax">tension pneumothorax</a> may result.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2022)">citation needed</span></a></i>]</sup> </p><p>Penetrating trauma can also cause injuries to the heart and circulatory system. When the heart is punctured, it may bleed profusely into the chest cavity if the membrane around it (the <a href="/wiki/Pericardium" title="Pericardium">pericardium</a>) is significantly torn, or it may cause <a href="/wiki/Cardiac_tamponade" title="Cardiac tamponade">pericardial tamponade</a> if the pericardium is not disrupted.<sup id="cite_ref-Smith98_15-0" class="reference"><a href="#cite_note-Smith98-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> In pericardial tamponade, blood escapes from the heart but is trapped within the pericardium, so pressure builds up between the pericardium and the heart, compressing the latter and interfering with its pumping.<sup id="cite_ref-Smith98_15-1" class="reference"><a href="#cite_note-Smith98-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Rib_fracture" title="Rib fracture">Fractures of the ribs</a> commonly produce penetrating chest trauma when sharp bone ends pierce tissues. </p> <div class="mw-heading mw-heading3"><h3 id="Abdomen">Abdomen</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=8" title="Edit section: Abdomen"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951" /><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/Abdominal_trauma" title="Abdominal trauma">Abdominal trauma</a></div> <p>Penetrating <a href="/wiki/Abdominal_trauma" title="Abdominal trauma">abdominal trauma</a> (PAT) typically arises from stabbings, ballistic injuries (shootings), or industrial accidents.<sup id="cite_ref-Management_of_Abdominal_Trauma_16-0" class="reference"><a href="#cite_note-Management_of_Abdominal_Trauma-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> PAT can be life-threatening because abdominal organs, especially those in the <a href="/wiki/Retroperitoneal_space" title="Retroperitoneal space">retroperitoneal space</a>, can bleed profusely, and the space can hold a large volume of blood.<sup id="cite_ref-Blank06_2-2" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> If the pancreas is injured, it may be further injured by its own <a href="/wiki/Secretion" title="Secretion">secretions</a>, in a process called <i>autodigestion</i>.<sup id="cite_ref-Blank06_2-3" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Injuries of the <a href="/wiki/Liver" title="Liver">liver</a>, common because of the size and location of the organ, present a serious risk for shock because the liver tissue is delicate and has a large blood supply and capacity.<sup id="cite_ref-Blank06_2-4" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The intestines, taking a large part of the lower abdomen, are also at risk of <a href="/wiki/Bowel_perforation" class="mw-redirect" title="Bowel perforation">perforation</a>. </p><p>People with penetrating abdominal trauma may have signs of <a href="/wiki/Hypovolemia" title="Hypovolemia">hypovolemic shock</a> (insufficient blood in the <a href="/wiki/Circulatory_system" title="Circulatory system">circulatory system</a>) and <a href="/wiki/Peritonitis" title="Peritonitis">peritonitis</a> (an inflammation of the <a href="/wiki/Peritoneum" title="Peritoneum">peritoneum</a>, the membrane that lines the <a href="/wiki/Abdominal_cavity" title="Abdominal cavity">abdominal cavity</a>).<sup id="cite_ref-Blank06_2-5" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Penetration may abolish or diminish bowel sounds due to bleeding, infection, and irritation, and injuries to arteries may cause <a href="/wiki/Bruit" title="Bruit">bruits</a> (a distinctive sound similar to <a href="/wiki/Heart_murmur" title="Heart murmur">heart murmurs</a>) to be audible.<sup id="cite_ref-Blank06_2-6" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Percussion of the abdomen may reveal <a href="/w/index.php?title=Hyperresonance&action=edit&redlink=1" class="new" title="Hyperresonance (page does not exist)">hyperresonance</a> (indicating air in the abdominal cavity) or dullness (indicating a buildup of blood).<sup id="cite_ref-Blank06_2-7" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The abdomen may be distended or tender, signs which indicate an urgent need for surgery.<sup id="cite_ref-Blank06_2-8" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>The standard management of penetrating abdominal trauma was for many years mandatory <a href="/wiki/Laparotomy" title="Laparotomy">laparotomy</a>. A greater understanding of mechanisms of injury, outcomes from surgery, improved imaging and interventional radiology has led to more conservative operative strategies being adopted.<sup id="cite_ref-Management_of_Abdominal_Trauma_16-1" class="reference"><a href="#cite_note-Management_of_Abdominal_Trauma-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Assessment_and_treatment">Assessment and treatment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=9" title="Edit section: Assessment and treatment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Assessment can be difficult because much of the damage is often internal and not visible.<sup id="cite_ref-Gupton02_4-3" class="reference"><a href="#cite_note-Gupton02-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The patient is thoroughly examined.<sup id="cite_ref-Blank06_2-9" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> X-ray and <a href="/wiki/Computed_tomography" class="mw-redirect" title="Computed tomography">CT scanning</a> may be used to identify the type and location of potentially lethal injuries.<sup id="cite_ref-Blank06_2-10" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Sometimes before an X-ray is performed on a person with penetrating trauma from a projectile, a paper clip is taped over entry and exit wounds to show their location on the film.<sup id="cite_ref-Blank06_2-11" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The patient is given <a href="/wiki/Intravenous_therapy" title="Intravenous therapy">intravenous</a> fluids to replace lost blood.<sup id="cite_ref-Blank06_2-12" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Surgery may be required; <a href="/wiki/Impalement" title="Impalement">impaled</a> objects are secured into place so that they do not move and cause further injury, and they are removed in an <a href="/wiki/Operating_theater" title="Operating theater">operating room</a>.<sup id="cite_ref-Blank06_2-13" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> If the location of the injury is not obvious, a surgical operation called an <a href="/wiki/Exploratory_laparotomy" title="Exploratory laparotomy">exploratory laparotomy</a> may be required to look for internal damage to the organs in the <a href="/wiki/Abdomen" title="Abdomen">abdomen</a>.<sup id="cite_ref-ATLS_Student_Course_17-0" class="reference"><a href="#cite_note-ATLS_Student_Course-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Foreign bodies such as bullets may be removed, but they may also be left in place if the surgery necessary to get them out would cause more damage than would leaving them.<sup id="cite_ref-Stewart05_12-1" class="reference"><a href="#cite_note-Stewart05-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> Wounds are <a href="/wiki/Debridement" title="Debridement">debrided</a> to remove tissue that cannot survive and other material that presents risk for infection.<sup id="cite_ref-Blank06_2-14" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>Negative pressure wound therapy is no more effective in preventing wound infection than standard care when used on open traumatic wounds.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=10" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Ambroise_Par%C3%A9.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/6/6a/Ambroise_Par%C3%A9.jpg/220px-Ambroise_Par%C3%A9.jpg" decoding="async" width="220" height="271" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/6/6a/Ambroise_Par%C3%A9.jpg/330px-Ambroise_Par%C3%A9.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/6/6a/Ambroise_Par%C3%A9.jpg/440px-Ambroise_Par%C3%A9.jpg 2x" data-file-width="680" data-file-height="839" /></a><figcaption>Ambroise Paré</figcaption></figure> <p>Before the 17th century, medical practitioners poured hot oil into wounds in order to <a href="/wiki/Cauterization" title="Cauterization">cauterize</a> damaged blood vessels, but the French surgeon <a href="/wiki/Ambroise_Par%C3%A9" title="Ambroise Paré">Ambroise Paré</a> challenged the use of this method in 1545.<sup id="cite_ref-Blank06quote_19-0" class="reference"><a href="#cite_note-Blank06quote-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> Paré was the first to propose controlling bleeding using <a href="/wiki/Ligature_(medicine)" title="Ligature (medicine)">ligature</a>.<sup id="cite_ref-Blank06quote_19-1" class="reference"><a href="#cite_note-Blank06quote-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> </p><p>During the <a href="/wiki/American_Civil_War" title="American Civil War">American Civil War</a>, <a href="/wiki/Chloroform" title="Chloroform">chloroform</a> was used during surgery to reduce pain and allow more time for operations.<sup id="cite_ref-Blank06_2-15" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Due in part to the lack of <a href="/wiki/Aseptic_technique" class="mw-redirect" title="Aseptic technique">sterile technique</a> in hospitals, infection was the leading cause of death for wounded soldiers.<sup id="cite_ref-Blank06_2-16" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>In <a href="/wiki/World_War_I" title="World War I">World War I</a>, doctors began replacing patients' lost fluid with salt solutions.<sup id="cite_ref-Blank06_2-17" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> With <a href="/wiki/World_War_II" title="World War II">World War II</a> came the idea of <a href="/wiki/Blood_bank" title="Blood bank">blood banking</a>, having quantities of <a href="/wiki/Blood_donation" title="Blood donation">donated blood</a> available to replace lost fluids. The use of <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a> also came into practice in World War II.<sup id="cite_ref-Blank06_2-18" class="reference"><a href="#cite_note-Blank06-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=11" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Aortic_dissection" title="Aortic dissection">Aortic dissection</a></li> <li><a href="/wiki/Ballistic_trauma" class="mw-redirect" title="Ballistic trauma">Ballistic trauma</a></li> <li><a href="/wiki/Blunt_splenic_trauma" title="Blunt splenic trauma">Blunt splenic trauma</a></li> <li><a href="/wiki/Blunt_trauma_personal_protective_equipment" title="Blunt trauma personal protective equipment">Blunt trauma personal protective equipment</a></li> <li><a href="/wiki/Geriatric_trauma" title="Geriatric trauma">Geriatric trauma</a></li> <li><a href="/wiki/Pediatric_trauma" class="mw-redirect" title="Pediatric trauma">Pediatric trauma</a></li> <li><a href="/wiki/Stab_wound" title="Stab wound">Stab wound</a></li> <li><a href="/wiki/Transmediastinal_gunshot_wound" title="Transmediastinal gunshot wound">Transmediastinal gunshot wound</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=12" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-StewartPrin05-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-StewartPrin05_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-StewartPrin05_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-StewartPrin05_1-2"><sup><i><b>c</b></i></sup></a></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFStewart_MG2005" class="citation book cs1">Stewart MG (2005). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=mOJpd-Sy1kgC&q=%22Penetrating+trauma%22&pg=PA195">"Principles of ballistics and penetrating trauma"</a>. In Stewart MG (ed.). <i>Head, Face, and Neck Trauma: Comprehensive Management</i>. Thieme. pp. <span class="nowrap">188–</span>94. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/3-13-140331-4" title="Special:BookSources/3-13-140331-4"><bdi>3-13-140331-4</bdi></a><span class="reference-accessdate">. Retrieved <span class="nowrap">2008-06-12</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Principles+of+ballistics+and+penetrating+trauma&rft.btitle=Head%2C+Face%2C+and+Neck+Trauma%3A+Comprehensive+Management&rft.pages=%3Cspan+class%3D%22nowrap%22%3E188-%3C%2Fspan%3E94&rft.pub=Thieme&rft.date=2005&rft.isbn=3-13-140331-4&rft.au=Stewart+MG&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DmOJpd-Sy1kgC%26q%3D%2522Penetrating%2Btrauma%2522%26pg%3DPA195&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Blank06-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-Blank06_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Blank06_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Blank06_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Blank06_2-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-Blank06_2-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-Blank06_2-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-Blank06_2-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-Blank06_2-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-Blank06_2-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-Blank06_2-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-Blank06_2-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-Blank06_2-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-Blank06_2-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-Blank06_2-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-Blank06_2-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-Blank06_2-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-Blank06_2-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-Blank06_2-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-Blank06_2-18"><sup><i><b>s</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBlank-Reid_C2006" class="citation journal cs1">Blank-Reid C (September 2006). "A historical review of penetrating abdominal trauma". <i>Crit Care Nurs Clin North Am</i>. <b>18</b> (3): <span class="nowrap">387–</span>401. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ccell.2006.05.007">10.1016/j.ccell.2006.05.007</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16962459">16962459</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Crit+Care+Nurs+Clin+North+Am&rft.atitle=A+historical+review+of+penetrating+abdominal+trauma&rft.volume=18&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E387-%3C%2Fspan%3E401&rft.date=2006-09&rft_id=info%3Adoi%2F10.1016%2Fj.ccell.2006.05.007&rft_id=info%3Apmid%2F16962459&rft.au=Blank-Reid+C&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Enepekides05-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-Enepekides05_3-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFEnepekidesDonald2005" class="citation book cs1">Enepekides DJ, Donald PJ (2005). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=mOJpd-Sy1kgC&q=%22Penetrating+trauma%22&pg=PA195">"Frontal sinus trauma"</a>. In Stewart MG (ed.). <i>Head, Face, and Neck Trauma: Comprehensive Management</i>. Thieme. p. 26. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/3-13-140331-4" title="Special:BookSources/3-13-140331-4"><bdi>3-13-140331-4</bdi></a><span class="reference-accessdate">. Retrieved <span class="nowrap">2008-06-12</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Frontal+sinus+trauma&rft.btitle=Head%2C+Face%2C+and+Neck+Trauma%3A+Comprehensive+Management&rft.pages=26&rft.pub=Thieme&rft.date=2005&rft.isbn=3-13-140331-4&rft.aulast=Enepekides&rft.aufirst=DJ&rft.au=Donald%2C+PJ&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DmOJpd-Sy1kgC%26q%3D%2522Penetrating%2Btrauma%2522%26pg%3DPA195&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Gupton02-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-Gupton02_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Gupton02_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-Gupton02_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-Gupton02_4-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFPollakGupton2002" class="citation book cs1">Pollak AN, Gupton CL (2002). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/emergencycaretra08edunse"><i>Emergency Care and Transportation of the Sick and Injured</i></a></span>. 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Rhee">Rhee, Peter M.</a>; Moore, Ernest E.; Joseph, Bellal; Tang, Andrew; Pandit, Viraj; Vercruysse, Gary (2016-06-01). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20200209160533/https://pdfs.semanticscholar.org/28b4/c33fdac67b3b5fa959a700c257877c50b9d2.pdf">"Gunshot wounds: A review of ballistics, bullets, weapons, and myths"</a> <span class="cs1-format">(PDF)</span>. <i><a href="/wiki/The_Journal_of_Trauma_and_Acute_Care_Surgery" title="The Journal of Trauma and Acute Care Surgery">The Journal of Trauma and Acute Care Surgery</a></i>. <b>80</b> (6): <span class="nowrap">853–</span>867. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FTA.0000000000001037">10.1097/TA.0000000000001037</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2163-0755">2163-0755</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26982703">26982703</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:42707849">42707849</a>. 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"Care of the critically ill patient with penetrating head injury". <i>Crit Care Nurs Clin North Am</i>. <b>18</b> (3): <span class="nowrap">321–</span>332. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ccell.2006.05.006">10.1016/j.ccell.2006.05.006</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16962454">16962454</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Crit+Care+Nurs+Clin+North+Am&rft.atitle=Care+of+the+critically+ill+patient+with+penetrating+head+injury&rft.volume=18&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E321-%3C%2Fspan%3E332&rft.date=2006&rft_id=info%3Adoi%2F10.1016%2Fj.ccell.2006.05.006&rft_id=info%3Apmid%2F16962454&rft.au=Blissitt+PA&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Stewart05-12"><span class="mw-cite-backlink">^ <a href="#cite_ref-Stewart05_12-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Stewart05_12-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFStewart_MG2005" class="citation book cs1">Stewart MG (2005). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=mOJpd-Sy1kgC&q=%22Penetrating+trauma%22&pg=PA195">"Penetrating trauma of the face"</a>. 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Retrieved <span class="nowrap">2008-06-12</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Thoracic+trauma&rft.btitle=Cardiovascular%2Frespiratory+physiotherapy&rft.place=St.+Louis&rft.pages=220&rft.pub=Mosby&rft.date=1998&rft.isbn=0-7234-2595-7&rft.aulast=Smith&rft.aufirst=M&rft.au=Ball%2C+V&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3DvzFR-ylAeSMC%26q%3Dsternal%2Bfracture%26pg%3DPA217&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Management_of_Abdominal_Trauma-16"><span class="mw-cite-backlink">^ <a href="#cite_ref-Management_of_Abdominal_Trauma_16-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Management_of_Abdominal_Trauma_16-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFFitzgeraldLarvin2009" class="citation book cs1">Fitzgerald, J.E.F.; Larvin, Mike (2009). "Chapter 15: Management of Abdominal Trauma". In Baker, Qassim; Aldoori, Munther (eds.). <i>Clinical Surgery: A Practical Guide</i>. <a href="/wiki/CRC_Press" title="CRC Press">CRC Press</a>. pp. <span class="nowrap">192–</span>204. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9781444109627" title="Special:BookSources/9781444109627"><bdi>9781444109627</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Chapter+15%3A+Management+of+Abdominal+Trauma&rft.btitle=Clinical+Surgery%3A+A+Practical+Guide&rft.pages=%3Cspan+class%3D%22nowrap%22%3E192-%3C%2Fspan%3E204&rft.pub=CRC+Press&rft.date=2009&rft.isbn=9781444109627&rft.aulast=Fitzgerald&rft.aufirst=J.E.F.&rft.au=Larvin%2C+Mike&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-ATLS_Student_Course-17"><span class="mw-cite-backlink"><b><a href="#cite_ref-ATLS_Student_Course_17-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite class="citation book cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20181221230523/https://www.44c.in.ua/files/book11.pdf"><i>Advanced Trauma Life Support Student Course Manual</i></a> <span class="cs1-format">(PDF)</span> (9th ed.). American College of Surgeons. Archived from <a rel="nofollow" class="external text" href="https://www.44c.in.ua/files/book11.pdf">the original</a> <span class="cs1-format">(PDF)</span> on 21 December 2018<span class="reference-accessdate">. Retrieved <span class="nowrap">17 December</span> 2018</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Advanced+Trauma+Life+Support+Student+Course+Manual&rft.edition=9th&rft.pub=American+College+of+Surgeons&rft_id=https%3A%2F%2Fwww.44c.in.ua%2Ffiles%2Fbook11.pdf&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-18"><span class="mw-cite-backlink"><b><a href="#cite_ref-18">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFIheozor-EjioforNewtonDumvilleCosta2018" class="citation journal cs1">Iheozor-Ejiofor, Zipporah; Newton, Katy; Dumville, Jo C; Costa, Matthew L; Norman, Gill; Bruce, Julie (2018-07-03). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513538">"Negative pressure wound therapy for open traumatic wounds"</a>. <i>Cochrane Database of Systematic Reviews</i>. <b>2018</b> (7): CD012522. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.cd012522.pub2">10.1002/14651858.cd012522.pub2</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1465-1858">1465-1858</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6513538">6513538</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29969521">29969521</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cochrane+Database+of+Systematic+Reviews&rft.atitle=Negative+pressure+wound+therapy+for+open+traumatic+wounds&rft.volume=2018&rft.issue=7&rft.pages=CD012522&rft.date=2018-07-03&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6513538%23id-name%3DPMC&rft.issn=1465-1858&rft_id=info%3Apmid%2F29969521&rft_id=info%3Adoi%2F10.1002%2F14651858.cd012522.pub2&rft.aulast=Iheozor-Ejiofor&rft.aufirst=Zipporah&rft.au=Newton%2C+Katy&rft.au=Dumville%2C+Jo+C&rft.au=Costa%2C+Matthew+L&rft.au=Norman%2C+Gill&rft.au=Bruce%2C+Julie&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6513538&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> <li id="cite_note-Blank06quote-19"><span class="mw-cite-backlink">^ <a href="#cite_ref-Blank06quote_19-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-Blank06quote_19-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222" /><cite id="CITEREFBlank-Reid_C2006" class="citation journal cs1">Blank-Reid C (September 2006). "A historical review of penetrating abdominal trauma". <i>Crit Care Nurs Clin North Am</i>. <b>18</b> (3): <span class="nowrap">387–</span>401. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ccell.2006.05.007">10.1016/j.ccell.2006.05.007</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16962459">16962459</a>. <q>Prior to the 1600s, it was common practice was to pour hot oil into wounds to cauterize vessels and promote healing. This practice was questioned in 1545 by a French military surgeon named Ambroise Pare who also introduced the idea of using ligature to control hemorrhage.</q></cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Crit+Care+Nurs+Clin+North+Am&rft.atitle=A+historical+review+of+penetrating+abdominal+trauma&rft.volume=18&rft.issue=3&rft.pages=%3Cspan+class%3D%22nowrap%22%3E387-%3C%2Fspan%3E401&rft.date=2006-09&rft_id=info%3Adoi%2F10.1016%2Fj.ccell.2006.05.007&rft_id=info%3Apmid%2F16962459&rft.au=Blank-Reid+C&rfr_id=info%3Asid%2Fen.wikipedia.org%3APenetrating+trauma" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Penetrating_trauma&action=edit&section=13" title="Edit section: External links"><span>edit</span></a><span 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class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q7162621" class="extiw" title="d:Q7162621">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/T14.1">T14.1</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" 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Score</a></li> <li><a href="/wiki/NACA_score" title="NACA score">NACA score</a></li> <li><a href="/wiki/Revised_Trauma_Score" title="Revised Trauma Score">Revised Trauma Score</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:12em">Investigations</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Diagnostic_peritoneal_lavage" title="Diagnostic peritoneal lavage">Diagnostic peritoneal lavage</a></li> <li><a href="/wiki/Focused_assessment_with_sonography_for_trauma" title="Focused assessment with sonography for trauma">Focused assessment with sonography for trauma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Management</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:12em">Principles</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Advanced_trauma_life_support" title="Advanced trauma life support">Advanced trauma life support</a></li> <li><a href="/wiki/Damage_control_surgery" title="Damage control surgery">Damage control surgery</a></li> <li><a href="/wiki/Early_appropriate_care" title="Early appropriate care">Early appropriate care</a></li> <li><a href="/wiki/Trauma_center" title="Trauma center">Trauma center</a></li> <li><a href="/wiki/Trauma_surgery" title="Trauma surgery">Trauma surgery</a></li> <li><a href="/wiki/Trauma_team" title="Trauma team">Trauma team</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:12em">Procedures</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Resuscitative_thoracotomy" title="Resuscitative thoracotomy">Resuscitative thoracotomy</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pathophysiology</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:12em"><a href="/wiki/Injury" title="Injury">Injury</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li>MSK <ul><li><a href="/wiki/Bone_fracture" title="Bone fracture">Bone fracture</a></li> <li><a href="/wiki/Degloving" title="Degloving">Degloving</a></li> <li><a href="/wiki/Joint_dislocation" title="Joint dislocation">Joint dislocation</a></li> <li><a href="/wiki/Soft_tissue_injury" title="Soft tissue injury">Soft tissue injury</a></li></ul></li> <li>Respiratory <ul><li><a href="/wiki/Diaphragmatic_rupture" title="Diaphragmatic rupture">Diaphragmatic rupture</a></li> <li><a href="/wiki/Flail_chest" title="Flail chest">Flail chest</a></li> <li><a href="/wiki/Hemothorax" title="Hemothorax">Hemothorax</a></li> <li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a></li> <li><a href="/wiki/Pulmonary_contusion" title="Pulmonary contusion">Pulmonary contusion</a></li></ul></li> <li>Cardio <ul><li><a href="/wiki/Cardiac_tamponade" title="Cardiac tamponade">Cardiac tamponade</a></li> <li><a href="/wiki/Internal_bleeding" title="Internal bleeding">Internal bleeding</a></li> <li><a href="/wiki/Thoracic_aorta_injury" title="Thoracic aorta injury">Thoracic aorta injury</a></li></ul></li> <li>GI <ul><li><a href="/wiki/Blunt_kidney_trauma" title="Blunt kidney trauma">Blunt kidney trauma</a></li> <li><a href="/wiki/Splenic_injury" title="Splenic injury">Splenic injury</a></li></ul></li> <li>Neuro <ul><li><a href="/wiki/Intracranial_hemorrhage" title="Intracranial hemorrhage">Intracranial hemorrhage</a></li> <li><a href="/wiki/Penetrating_head_injury" title="Penetrating head injury">Penetrating head injury</a></li> <li><a href="/wiki/Traumatic_brain_injury" title="Traumatic brain injury">Traumatic brain injury</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:12em">Mechanism</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Blast_injury" title="Blast injury">Blast injury</a></li> <li><a href="/wiki/Blunt_trauma" title="Blunt trauma">Blunt trauma</a></li> <li><a href="/wiki/Burn" title="Burn">Burn</a></li> <li><a href="/wiki/Crush_injury" title="Crush injury">Crush injury</a></li> <li><a href="/wiki/Electrocution" title="Electrocution">Electrocution</a></li> <li><a href="/wiki/Gunshot_wound" title="Gunshot wound">Gunshot wound</a></li> <li><a class="mw-selflink selflink">Penetrating trauma</a></li> <li><a href="/wiki/Stab_wound" title="Stab wound">Stab wound</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:12em">Region</th><td class="navbox-list-with-group navbox-list navbox-even" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Abdominal_trauma" title="Abdominal trauma">Abdominal trauma</a></li> <li><a href="/wiki/Chest_injury" title="Chest injury">Chest injury</a></li> <li><a href="/wiki/Facial_trauma" title="Facial trauma">Facial trauma</a></li> <li><a href="/wiki/Head_injury" title="Head injury">Head injury</a></li> <li><a href="/wiki/Spinal_cord_injury" title="Spinal cord injury">Spinal cord injury</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:12em">Demographic</th><td class="navbox-list-with-group navbox-list navbox-odd" style="padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Geriatric_trauma" title="Geriatric trauma">Geriatric trauma</a></li> <li><a href="/wiki/Trauma_in_children" title="Trauma in children">Pediatric trauma</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Complications</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">Acute respiratory distress syndrome</a></li> <li><a href="/wiki/Chronic_traumatic_encephalopathy" title="Chronic traumatic encephalopathy">Chronic traumatic encephalopathy</a></li> <li><a href="/wiki/Compartment_syndrome" title="Compartment syndrome">Compartment syndrome</a></li> <li><a href="/wiki/Contracture" title="Contracture">Contracture</a> <ul><li><a href="/wiki/Volkmann%27s_contracture" title="Volkmann's contracture">Volkmann's contracture</a></li></ul></li> <li><a href="/wiki/Crush_syndrome" title="Crush syndrome">Crush syndrome</a> <ul><li><a href="/wiki/Rhabdomyolysis" title="Rhabdomyolysis">Rhabdomyolysis</a></li></ul></li> <li><a href="/wiki/Embolism" title="Embolism">Embolism</a> <ul><li><a href="/wiki/Air_embolism" title="Air embolism">air</a></li> <li><a href="/wiki/Fat_embolism_syndrome" title="Fat embolism syndrome">fat</a></li></ul></li> <li><a href="/wiki/Post-traumatic_stress_disorder" title="Post-traumatic stress disorder">Post-traumatic stress disorder</a></li> <li><a href="/wiki/Subcutaneous_emphysema" title="Subcutaneous emphysema">Subcutaneous emphysema</a></li> <li><a href="/wiki/Wound_healing" title="Wound healing">Wound healing</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374" /><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235" /></div><div 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