Medico-legal Importance Of Wounds

Medico-legal importance of abrasions, bruises, contused wounds: vista: visda Abr asions

Bruise s

Con tuse d Wound s

V: violence I: causative

evidence of violence

evidence of violence

evid en ce of vi ol enc e

By shape: Fingernail abrasions. Teeth abrasions. Car radiator abrasions.

Ra re evi de nc e

S: site

Give idea about type of crime: Finger nail around neck: th rott li ng Fingernails on inner side of thighs: rap e. Rarely cause death.

By shape: Longitudinal line: ha rd st ic k. 2 parallel lines: rubb er st ic k. 2 parallel lines around body Curvatures: whi p. Curved raws of lines: Hum an b it es. Parallel raws of lines: An im al bites . Give idea about type of crime: Bruises on neck: throt tl in g.

Only if: Extensive. Infected. With internal hge.

Wi th : S ep si s. D isfi gur in g sca rs. In tern al h ge .

instrument

D: danger

differentiate

Cut& contused wounds. Homicidal& suicidal wounds. Hyptosis& bruises.

Cut& contused wounds. + it must be differentiated from Hyptosis Pg. 54

+ direction of tangential abrasions: Starting edge. Parallel furrows. Terminal epidermal tag.

A: age

1 st da y: cov er of d ry sca b. > 3 d ays: d ry b rown sca b. > 1 wee k: scab fa ll s l eavi ng r ed ar ea . > 2 wee ks: r ed a re a d is app ea rs (n o sca rs).

1 st da y: r ed (oxy Hb) . 1-3 da ys: b lu e (r ed uced Hb ). 4-5 da ys: g re en (b il iver di n) . 5-1 0 da ys: yel low (b il iru bi n) . 2-3 week s: he al s.

Ra re evi de nc e.

Hom ic ida l& s uic id al wou nds ra re ly su ic ida l + i t mus t b e dif fer en tia ted fr om in ci se d w ou nds : Ab ra si on s& bru is es. R agge d edg es . Com pr es sed bas e wi th t is su e bri dg es .

Medico-legal importance of incised (cut) wounds: vista: visda V: evidence of violence. I: used instrument: Indicate sharp edged instrument but not its type except if glass particles are found.

S: site: Rare evidence except elected site to suicidal cut wounds. D: danger: depend on site& depth.

In the neck may be associated by profuse ext. hge, air embolism. Direction of incision: as it is deeper at site of start. Differentiation: Should be differentiated from contused as it may have irregular edges: In redundant skin as scrotum, axilla, abdomen of obese. Or if caused by irregular jagged sharp instrument as broken glass. Should be differentiated if suicidal or homicidal or accidental: 1- Self-inflected : Suicidal : sites of election: wrist, neck, cubital fossa, chest, abdomen, groin. Associated with intentative marks. Fabricated: superficial wounds of had, lt. arm, abdomen… Para suicidal mutilation: in the face, arms, trunk… 2- Assault incision (homicidal): ● At any site. ● No intentative marks. ● No repetition in the same track. ● Associated with defense injuries. 3- Accidental: ● random pattern. ● Single. ● Often deep, forceful.

A: age: indicate time of inflection by histological examination: 30 min.- 4 hs: migration of PMN leucocytes. 4hs – 12 hs: ● leucocytes demarcate the wound by marginal palisading. ● Mitosis of fibroblasts. ● Epidermis tends to spread across the scab. ● Budding of capillary loops. 36 hs: complete capillary net work. 48 hs: ● new vs. grow from deep layers. ● Sepsis may occur. 5 days: obliteration of vs. 10-15 days: complete healing by 1ry intention (if no sepsis). 3 weeks: red scar. 3 months: coppery scar. 6 months: thin, pale scar (not even detected).

Medico-legal importance of stab wounds: lie L: bl. Loss.

I: manner of injury. E:

examination& description 3s, 4d.

1- Bl. Loss ● external: may be little or absent. ● internal: may be profuse& also it may hide serious damage int. organ. 2- Manner of Injury: ● Homicidal: multiple, scattered, different directions, associated with defense Wound. ● Suicidal: single, one fatal wound, one special direction, associated with tentative wounds. 3- Examination& description of wounds: 3s , 4d

☺Shape: all dimensions with the edge reapposed. ☺Size: give idea about weapon used. ☺Site: relative to anatomical landmark e.g. midline, heel, crown of head … ☼ Direction of thrust: depth is more at starting point. ☼ Damage of tissues along wound track. ☼ Dangers (complications): hge, pneumothorax, air embolism. ☼ Depth of wound track: ■ Specific character of stab wound leading to injury of bl.vs or int. organs causing int. hge. ■ should be interpreted with caution as postmortem examination takes place with the body lying flat on the back so it may not be the same as if he was standing or sitting during life.