Contact range entry wounds can appear stellate where there is relatively thin skin and soft tissue overlying bone (e.g., the head; see Figs. 14, 15, 26, and 27 and ref. 16). This mimics an exit wound. Gas blowback and energy dissipation result in the skin being temporarily lifted from the bony surface and splitting (16). In high-velocity injuries, tissue can be ejected from the entrance, giving the false impression of tissue extruded from an exit ( 16,151 ). The tearing can be severe if there is a high volume of gas (e.g., tear gas cartridge, high-velocity rifle, shotgun [16,93]). A high-velocity wound of the mouth can be associated
with extensive fracturing of the skull and tearing around the nose, eyes, and mouth (16). Perioral "stretch" lacerations are limited to mouth entries (Fig. 28; ref. 138). Extensive tearing of the wound requires approximation of the skin edges to determine the entry site (Fig. 29; ref. 16). Distant wounds may be stellate if a projectile enters a bony prominence (e.g., supraorbital ridge, zygoma, mandible [16,132,152]). Tearing is enhanced if the bullet is distorted or tumbles. A bullet entering and exiting the same hole can partly tear the wound edge (e.g., .38-caliber revolver, right temple entry ). Certain types of weapons have been described as causing "irregular" entries (119). Falling, after wounding by a firearm, causes cutaneous injuries (e.g., facial abrasion ).
Lifting of the skin against the barrel of the handgun, rifle, or shotgun can result in a muzzle imprint (Figs. 26 and 30 and ref. 16). It can be used to correlate a weapon with an injury, particularly if no bullet is recovered; however, the muzzle imprint can be larger than the actual size on the weapon (16,113). The finding of a muzzle imprint also supports the circumstances of a multishot suicide (22,57,59,62). Variations of a muzzle imprint have been seen when a blank cartridge, nail gun, or ejector rod is involved (73,85,92,107).
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