Which of the following is the characteristic feature that distinguishes an entrance wound from an exit wound in a firearm injury?

## Entrance vs Exit Wounds in Firearm Injuries ### Key Distinguishing Features **Key Point:** The entrance wound is typically SMALLER with beveling directed INWARD (into the tissues), while the exit wound is typically LARGER with beveling directed OUTWARD (away from the tissues). ### Detailed Comparison | Feature | Entrance Wound | Exit Wound | |---------|---|---| | **Size** | Smaller | Larger | | **Beveling** | Inward (concave on external surface) | Outward (convex on external surface) | | **Abrasion collar** | Present (due to friction as bullet enters) | Absent or minimal | | **Tissue damage** | More localized | More extensive | | **Shape** | Usually round/oval | Often irregular/stellate | | **Margins** | Clean, punched-out appearance | Ragged, irregular | ### Mechanism of Beveling 1. **Entrance wound beveling:** As the bullet penetrates the skin and underlying tissues, it creates a cone-shaped defect with the narrower end on the external surface and wider end internally — this is **inward beveling**. 2. **Exit wound beveling:** As the bullet exits, it pushes tissues outward, creating a defect that is wider on the external surface and narrower internally — this is **outward beveling**. **High-Yield:** Beveling direction is one of the most reliable ways to differentiate entrance from exit wounds, especially in cases of tangential or ricochet injuries where size alone may be misleading. **Clinical Pearl:** In contact or close-range shots, the entrance wound may show soot deposition and/or powder tattooing, which are NEVER seen in exit wounds. ### Exception: Multiple Gunshot Wounds When a bullet passes through the body and creates both entrance and exit wounds, the exit wound of the first tissue layer becomes the entrance wound of the next layer, so beveling direction must be assessed relative to each specific tissue layer.