A new model for the characterization of infection risk in gunshot injuries:Technology, principal consideration and clinical implementation

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.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.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.In addition to complex traumata, gunshot injuries can cause wound infections at the bullet's entrance or exit and within the bullet path. Since the skin as a barrier against bacteria is injured, a wound can fundamentally be assumed to be contaminated with clothing particles, skin bacteria and air bacteria [1]. Current scientific research on possible contaminations along permanent or temporary wound cavities and the resulting surgical recommendations are topics of controversial debate in medical literature [2]. This is not least due to the fact that there is still a lack of clarity about some of the phenomena leading to a temporary wound cavity [3]. Advances in technology are leading to an increase in injuries caused by high-velocity projectiles especially in military conflicts [4]. The temporary wound cavities caused by high-velocity projectiles are significantly wider in diameter, resulting in more extensive tissue destruction [5,6]. The