Correspondence (letter to the editor): Supplement to Forensic Analysis

Franke et al. present a relevant overview of primary care and hospital treatment of gunshot and blast injuries (1). However, the measures given for forensic analysis, inaccurately presented under “Goals of further treatment,” require further clarification.

Time constraints when treating patients with such injuries often make it unrealistic for a crime scene technician or forensic expert to be consulted for evidence collection. Therefore, every surgeon should have basic knowledge about the evidence collection for gunshot injuries.

In addition to the four evidence objects mentioned in the text (projectiles, fragments, clothing, and potentially relevant objects), the following are also important for allowing event reconstruction (2, 3):

• Skin sample taken on self-adhesive dressing material.

• Dressing material used during first aid.

• Excised material from the wound.

• Imaging examinations

• Photographs of injuries

In general, the physician giving first aid cannot determine which of the listed evidence objects will be relevant during event reconstruction.

When dealing with gunshot injuries, numerous pieces of evidence can be lost relatively quickly (for example, gunshot residue lost by skin disinfection); therefore, evidence should be collected as soon as possible. Importantly, following recommendations for safeguarding gunshot evidence in the clinical area can contribute decisively to determining criminal acts and to classifying unclear gunshot injuries (Accident? Suicide? Homicide?).

In the case of non–self-inflicted wounds, an appropriate forensics analysis is in the mutual interests not only of the patient, law enforcement, and the legal system but also of the attending physician, who would be expected to testify as an expert witness in court. If permitted by time constraints during the first aid response, it is advisable to consult a forensic expert.