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This is great.

However, I feel like "Puncturing" should be less about missiles and more general to accomodate other puncturing stuff (IE: Spear, ice pick, awl, needle, spike etc.). Or perhaps split up into "Puncturing" and "Missiles".

That's fair, yeah. Personally, I'd prefer to adapt the puncturing wound description on-the-fly to fit the damage source, instead of adding another category to the system. Maybe a "shot in the eye" wound with a spear means the blade came in at an angle, from the side of the head to the nose? Something like that.

Thanks for the message!