In penetrating trauma, which wound is larger and more serious?

• A. Entry wound
• B. Exit wound
• C. Laceration
• D. Abrasion

Answer: (B)

When a projectile penetrates, the energy it carries is dumped into the tissues as it travels. This energy transfer, along with possible yawing, fragmentation, or tearing as it exits, causes significant disruption to surrounding tissue. The exit wound tends to be larger and more irregular because the tissue has already been stretched and torn by the projectile’s passage, making it the more serious wound in penetrating trauma. The entry wound is usually smaller and neater, since the skin initially yields to the incoming projectile with less outward tearing. Lacerations and abrasions describe different wound patterns (tears from blunt/sharp forces and superficial scrapes, respectively) and are not the primary descriptors for penetrating ballistic injuries.