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Kinetic energy delivered from the high velocity of a water jet is the primary determinant of tissue disruption. The water stream disperses when it strikes the skin, tracking along tissue planes, and manifesting as a small entrance wound with a wider zone of internal injury. This pattern of injury is similar to that of high velocity missiles, like military and hunting rifles. Dissipating energy can also cause a blast pattern of injury where the damage is caused by pressure waves rather than direct penetrating injury.