shell explosions caused burning hot metal to fly out at high speed which was called shrapnel. shrapnel accounted for 58% of wounds, some being shrapnel embedded in the brain, skull fractures, brain damage, concussion and facial injuries. solutions to prevent injury caused by shrapnel included the Brodie helmet 1915, Harold Gillies developed a plastic surgery technique which made skin grafting and facial reconstruction more effective. also Dr Harvey Cushing used x-rays to find shrapnel in the brain and drew it out using magnets.