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Introduction: Surgical treatment of high-energy gun-shot wounds (GSWs) to the extremities is challenging. Recent surgical doctrine states that wound tracts from high-energy GSWs should be laid open, however the experience from previous conflicts suggests that some of these injuries can be managed more conservatively. The aim of this study is to firstly characterise the GSW injuries sustained by UK forces, and secondly test the hypothesis that the likely severity of GSWs can be predicted by features of the wound.Methods: The UK Military trauma registry was searched for cases injured by GSW in the five years between 01 January 2009 and 31 December 2013: only UK personnel were included. Clinical notes and radiographs were then reviewed. Features associated with energy transfer in extremity wounds in survivors were further examined with number of wound debridements used as a surrogate marker of wound severity.Results: There were 450 cases who met the inclusion criteria. 96 (21%) were fatally injured, with 354 (79%) surviving their injuries. Casualties in the fatality group had a median New Injury Severity Score (NISS) of 75 (IQR 75-75), while the median NISS of the survivors was 12 (IQR 4-48) with 10 survivors having a NISS of 75. In survivors the limbs were most commonly injured (56%). 'Through and through' wounds, where the bullet passes intact through the body, were strongly associated with less requirement for debridement (p<0.0001). When a bullet fragmented there was a significant association with a requirement for a greater number of wound debridements (p=0.0002), as there was if a bullet fractured a bone (p=0.0006).Conclusions: More complex wounds, as indicated by the requirement for repeated debridements, are associated with injuries where the bullet does not pass straight through the body, or where a bone is fractured. Gunshot wounds should be assessed according to the likely energy transferred, extremity wounds without features of high energy transfer do not require extensive exploration. [ABSTRACT FROM AUTHOR]

Simple Summary: Cetacean strandings are frequent in occurrence and are likely to become even more common globally because of the effects of escalating anthropogenic activities. Due to the compromised state of stranded animals, euthanasia is often recommended or required. However, current knowledge and implementation of euthanasia methods remain highly variable, with limited data on the practicalities and welfare impacts of procedures. This study sought to evaluate the available published data on cetacean euthanasia in order to highlight significant knowledge gaps and provide direction to improve the welfare of stranded cetaceans. Data from the peer-reviewed literature and published reports were analysed, and significant knowledge gaps highlighted. Two main euthanasia methods, chemical and ballistics, were reported, with few details provided on the specific application of these. Few data were available about time to death/insensibility, parameters commonly required to assess the welfare impacts of killing methods. Overall, the findings highlight the lack of available information on cetacean euthanasia and suggest avenues for future work to improve welfare through the use of appropriate methods and increased data collection. The compromised state of stranded cetaceans means that euthanasia is often required. However, current knowledge and implementation of euthanasia methods remain highly variable, with limited data on the practicalities and welfare impacts of procedures. This study evaluated the available published data on cetacean euthanasia, highlighting knowledge gaps and providing direction to improve stranded cetacean welfare. A total of 2147 peer-reviewed articles describing marine mammal euthanasia were examined. Of these 3.1% provided details on the method used, with 91% employing chemical methods. Two countries, the United Kingdom (UK) and New Zealand (NZ), provided euthanasia reports to the International Whaling Commission (IWC) between 2007 and 2020. Methods employed were reported for 78.3% and 100% of individual cetaceans euthanised in the UK and NZ, respectively. In the UK, chemical euthanasia was most common (52%), whilst in NZ only ballistics methods were used. Few data were available about time to death/insensibility (TTD); 0.5% of peer-reviewed articles provided TTD, whilst TTD was reported for 35% of individuals in the UK and for 98% in NZ. However, IWC reports lacked detail on how death/insensibility were assessed, with multiple individuals "presumed instantly" killed. Overall, the findings highlight the lack of available information on cetacean euthanasia, and suggest increased data collection and the application of appropriate methods to improve welfare. [ABSTRACT FROM AUTHOR]