TY - JOUR T1 - Small Fragment Wounds: Biophysics, Pathophysiology and Principles of Management JF - Journal of the Royal Army Medical Corps JO - J R Army Med Corps SP - 41 LP - 51 DO - 10.1136/jramc-147-01-04 VL - 147 IS - 1 AU - PF Hill AU - DP Edwards AU - GW Bowyer Y1 - 2001/02/01 UR - http://militaryhealth.bmj.com/content/147/1/41.abstract N2 - Military surgical doctrine has traditionally taught that all ballistic wounds should be formally managed by surgical intervention. There is now, however, both experimental and clinical evidence supporting the nonoperative treatment of selected small fragment wounds. Low energytransfer wounds affecting the soft tissues, without neuro-vascular compromise and with stable fracture patterns, may be suitable for early antibiotic treatment. The management of ballistic wounds to the gastrointestinal tract requires surgical intervention but, advances in the treatment of these wounds, especially those involving the colon, may allow more effective treatment with a reduced morbidity. ER -