Forensic Pathology for Police - Brainshare Public Online Library

Gunshot Wounds 351
Exit Wounds
Exit wounds from low-velocity firearms tend to be relatively small, and they can
have a variety of shapes, ranging from slit-like to comma-shaped to X-shaped to
irregularly-shaped (Figs. 13.17 and 13.18 and Disc Images 13.33, 13.34, and 13.35).
Exit wounds may or may not have central, round to oval defects, but the typical exit
wound does not have marginal abrasions. In certain circumstances, however, an exit
wound can mimic a classic entrance wound. This occurs when the skin surrounding
the exit site is supported (“shored-up”) by firm, tight clothing or another firm object
(wall, concrete floor, etc.). The resulting exit wound is referred to as a “shored” exit
wound (Fig. 13.19). High-velocity exit wounds tend to be very large and destructive
(see below). Frequently bullets lack enough energy to actually exit the body and
may remain just underneath the skin surface. Sometimes, their presence is obvious
(Fig. 13.20) and occasionally is indicated by subcutaneous hemorrhage (Disc Image
13.36).
Fig. 13.17 A stellate exit wound. Note the absence of a central round defect (a feature which is
characteristic of an entrance wound)
Graze Wounds
Graze gunshot wounds (those that strike the skin surface in a tangential fashion) are
not uncommon. They can range from wounds that only injure the very superficial
layers of the epidermis to those that completely disrupt the epidermis and also injure
the underlying dermis, and possibly the subcutaneous fatty tissues. The typical graze
wound has an elongated oval shape, with an elongated marginal abrasion being seen
at both ends of the elongated oval shape; however, it is more typical at the end that
the bullet struck first. The direction of the travel of the bullet can be determined if
the wound is deep enough to produce a series of pointed-tip “skin tags” along the