Jourdan P, Vicq P
Neurochirurgien des Hôpitaux des Armées, H.I.A., Toulon Naval.
J Chir (Paris). 1991 Feb;128(2):59-64.
This paper analyzes a publication of wound ballistic from MM. Cooper and Ryan published in British Journal of Surgery 1990, vol. 77 June pp. 606-610 which call "Interaction of penetrating missiles with tissues: some common misapprehensions and implications for wound management". MM. Cooper and Ryan describe interaction of penetrating missiles with tissues, they denounce that they call common misapprehensions in wound ballistic and they try to reconcile engineers works and clinical observations. As a result of this synthesis, a management of war injuries is recommended. Authors of this present paper do a methodical analysis of the British publication and denounce: 1. the experimental method and the "energy-transfer" concept; 2. two contradictories and irreconcilable doctrines promulgated in wound ballistic world which are in one hand supporters of 5.56 bullets shock wave giving distant wounds and iatrogenic mutilations, on the other hand, supporter of wounds treatment without any need to know the weapon; 3. differences between wounds of war and peacetime is sometime more theoretical than real and may give the place to the concept of circumstances surgery.
本文分析了MM. 库珀和瑞安于1990年发表在《英国外科杂志》第77卷6月期第606 - 610页上的一篇关于创伤弹道学的论文，题目为《穿透性导弹与组织的相互作用：一些常见误解及对伤口处理的影响》。MM. 库珀和瑞安描述了穿透性导弹与组织的相互作用，谴责了他们所谓的创伤弹道学中的常见误解，并试图协调工程师的工作和临床观察结果。通过这种综合，推荐了一种战伤处理方法。本文作者对这篇英国文献进行了系统分析并谴责：1. 实验方法和“能量传递”概念；2. 创伤弹道学界宣扬的两种相互矛盾且无法调和的学说，一方面是支持5.56子弹冲击波会造成远距离伤口和医源性致残的观点，另一方面是支持无需了解武器即可进行伤口治疗的观点；3. 战争伤口与和平时期伤口之间的差异有时更多是理论上的而非实际的，这可能会催生情境外科的概念。
