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Clearly the more recent studies have a higher NOS score. Due to different inclusion and exclusion criteria, data extraction and outcomes of interest a statistical test for heterogeneity (ea. I2 test) is not suitable to evaluate these differences. It even could be argued that the term heterogeneity is not applicable, although with a narrative description as given in this systematic review, heterogeneity is the most suitable term. There was heterogeneity among the included studies and there were major differences in inclusion and exclusion criteria regarding the target population among the included trials leading to bias. Overlap was minimized by exact identification of the research period in relation to the inclusion criteria ( Fig. 3). [http://en.wikipedia.org/wiki/PSCD4 CYTH4] Because of different nationalities, locations of the medical treatment facility (different casualties) and inclusion [http://www.selleckchem.com/products/AG-014699.html learn more] criteria, the effects of possible overlap are limited. Although the risk of overlap is clearly present, it can contribute to a good impression of the mechanism of injury and anatomical disposition of wounds. A total of seven studies [6], [23], [24], [25], [26], [27]?and?[28] (totalling to a number of n?=?19,671 BC) contributed to the further analysis ( Table 2). Patel et al. [22] did not describe the mechanism of injury, therefore this study was excluded in this part of the analysis. There was heterogeneity among studies which is presented in Table 2. The overall [6], [23], [24], [25], [26], [27]?and?[28] distribution in mechanism of injury was GSW 18%, explosion 72%, other (crash fixed or rotary wing, motor vehicle accident, other accident, burns, self-inflicted within hostile action, fire of own troops and unknown) 10%. There was a significant difference (p?[http://www.selleckchem.com/products/CAL-101.html GS-1101 purchase] and Lechner et al. [25], introducing a high risk of bias. A total of eight studies [6], [22], [23], [24], [25], [26], [27]?and?[28] (totalling to a number of n?=?18,830) contributed to the analysis ( Table 3). Belmont et al. [6], Eastridge et al. [27] and Hoencamp et al. [28] included fewer BC in the analysis of the anatomical distribution of wounds. There was heterogeneity among studies, and the differences are presented in Table 3. The overall anatomical distribution of wounds was head and neck 31%, truncal (chest-abdomen) 27%, extremity 39% and other/unknown 3%. There was a significant difference (p?