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High-velocity Mauser and Lee-Metford small-calibre bullets create narrow entry and exit apertures with remarkably little tissue destruction compared to older large-calibre lead projectiles. Clean perforations occur when bullets hit at high velocity without striking dense bone. When the hard jacket ruptures or bullet velocity drops, severe laceration and explosive tissue disruption result.
Bullets passing close to major arteries often contuse or partially sever the vascular wall without causing instant fatal external bleeding. Arteriovenous aneurysms and false aneurysms develop frequently as surrounding tissues contain the blood flow. Conservative management and delayed surgical intervention yield far better recovery rates in field hospitals than immediate arterial ligature.
Dense long bones hit by high-velocity bullets suffer extensive comminuted fractures with sharp radiating splinters. Compact cancellous bone in joints often sustains neat cylindrical perforations that heal without extensive suppuration. Antiseptic dressing and immobilization preserve limbs that in earlier campaigns would have required immediate amputation.
Penetrating abdominal bullet wounds treated conservatively with absolute rest and starvation yield lower mortality rates than immediate laparotomy in field hospitals. Small-calibre bullets create minute intestinal perforations that seal quickly through localized peritoneal adhesion. Moving patients prematurely or opening the abdominal cavity under battlefield conditions introduces fatal sepsis.
A pioneering study of high-velocity bullet wounds and battlefield surgery during the Second Boer War.