Abstract:
Gunshot wounds are one of the most serious problems of modern medicine, as they are characterized by significant destructive tissue damage, high mortality and complexity of treatment. In modern conditions of military conflicts, terrorist threats and increasing crime rates, the number of such wounds is steadily increasing, which requires improving methods of diagnosis, treatment and forensic examination. Gunshot wounds have specific features that depend on the caliber, design of the ammunition, the distance of the shot and the anatomical localization of the wound channel. Not only the issue of surgical treatment of wounds is important, but also the assessment of their consequences, which is important for both clinical medicine and forensic practice. The aim of the study is to analyze the current state of the problem of the pathology of gunshot wounds, including the features of their morphology, mechanisms of tissue damage, complications and approaches to
treatment and forensic diagnostics. To achieve this goal, a search for scientific sources was conducted in international and domestic databases that cover the morphological and clinical aspects of gunshot wounds. An analysis of the current literature covering the issues of ballistic trauma, pathophysiological changes in damaged tissues, diagnostic criteria and treatment approaches was performed. The results of the study showed that the morphological features of gunshot wounds largely depend on the kinetic energy of the projectile, its shape and speed. The main lesions include the primary shock wave, the formation of a temporary and permanent cavity, as well as secondary damage due to hydrodynamic impact. It was found that gunshot wounds have a high frequency of complications, including infectious processes, tissue necrosis, impaired regeneration and the development of chronic pain syndrome. Forensic medical examination of these injuries is based on the analysis of macro- and microscopic changes in tissues, which allows to establish the mechanism of injury, the distance of the shot and the type of ammunition. Thus, gunshot wounds remain a complex medical and forensic problem that requires
improvement of diagnostic approaches. Modern imaging methods, in particular computed tomography and magnetic resonance imaging, allow for a detailed assessment of the direction of the wound canal, the degree of tissue damage, and the presence of foreign bodies. The use of histological and immunohistochemical methods contributes to the accurate determination of the nature of the lesion, the characteristics of reparative processes, and the presence of signs of infectious complications. Further research aimed at improving instrumental diagnostic methods will improve the detection of pathomorphological changes.
