PUTREFACTION

By Dr. Naveen

Putrefaction:
 Decomposition  “It is the process in which the complex organic substances are converted into simpler one by the action of the proteolytic enzymes of the tissue and living saprophytic microorganisms”.

 Causes: AutolysisCl.welchi,streptococci,staphylococci,proteus,d iphtheroids etc.

Stages of putrefaction:
    1.colour change 2.Development of foul smelling gases 3.Appearance of maggots 4.Colliquative putrifaction

 1.colour change: -externally: 1st seen in the abdominal skin,caecum greenish discoloration -internally: under surface of the liver -Appears : 12-18 hrs. summer 1- 2 days winter -it is due to decomposituon of haemoglobin into greenish compound that stain the skin. -it usually starts in right iliac fossa. -Extends to external genitalia,chest,neck,face,arms and legs -Deepens,dark green , dark blue

 2.Development of foul smelling gases: -nauseating and unpleasant smell -later collects in the abdomen -abdomen tense and distended -collects in the hollow visceras & t/s -blisters -faces swollen -rectum protrudes  Time of development: -12-18 hrs summer -1-2 days winter

 3.appearance of maggots: -flies are attracted by the smell -lay their eggs -forms larva(maggots) -hatch into pupae( in 4-5 days) -adult fly ( another 4-5 days) - scalp & nails become loose - teeth become loose - sutures of the skull -liquified brain

 4.colliquative putrifaction: -after 5-10 days -abdomen burst - in children thorax also bursts - T/s becomes loose,seperated from bones and falls off - bones are distroyed

Time during putrefaction
 Color changes; 12-18 hrs summer 1-2 days winter  Development of foul smelling gases; -gases collects in intestine:12-18 hrs -collects in hollow viscera: 24-36 hrs -blisters: 36-48 hrs -swollen faces: 36-48 hrs. -rectum protrudes: 48-72 hrs.  Appearance of maggots: 18-36 hrs  Teeth fall out: 3-7 days  Sutures of the skull become loose: 5-12 days  Body is skeletonized : 1-3 months

 Putrefaction rapid in : septicaemia, peritonitis intestinal obstruction pyelonephritis women dying after child birth  Slow in : anaemia malnutrition poisoning if submerged in water

Putrefaction of internal organ :
 According to Taylor: -intestine and stomach -liver -spleen -brain -lungs -kidney -bladder -prostate /testis (M) -Uterus,ovaries (F)

 According to Reddy: -Larynx and trachea -stomach/intestine/spleen -liver/lungs -brain -heart -kidney/bladder/uterus -skin/muscle tendons -bones

 !!!

SAPONIFICATION
 Adipocere formation  “It is the modification of putrefaction in which the body fat is converted into a brown wax like substances which occurs in bodies submerged under water for appreciable time or burried in moist grave or water lodged soil”.

 Mechanism: -the fatty t/s changes into substance known as adipocere. -it is due to gradual hydrolysis of preexisting fats into higher fatty acid.

Time required for adipocere formation:
 Varies greatly  In summer : 3 weeks may take 6wks- 12 months  In winter : may take shorter time not exactly known

Distribution:
 Common site: face/buttock/breast & abdomen  Less common: limbs/chest wall

Medicolegal importance:
    Helps in identification long after death Causes of the death can be recognized May indicate place of burial Can estimate time

Mummification:
 Desication  “It is the drying and shrivelling of the body tissue due to rapid dehydration of the body in a dry and hot climate and which retains the natural appearance of the body.”

Factors influencing Mummification:
   1.Absence of dampness 2.Dry or warmed air 3.Marked dehydration before death

Time required:
 Not exactly known  Months to year

Medicolegal importance:
    Identification Cause of death Time ,, ,, Place ,, ,,

Exhumation:
 “Exhumation means digging out of an already buried body from the grave for such medicolegal purpose as identification or autopsy in case of suspicious death from foul play.”

 Who can order exhumation?? written order from district magistrate or any other magistrate inpowered by the government.

Indication :
   In any suspicious of foul play or poisoning To established identity To detect the time of death

Procedure:
 Written order by the magistrate  Exhumated under the supervision of MO,in the presence of police officer  To be carried out in day light  Exact situation of the grave  If possible identify by name plate  Wear gloves and mask  Collect several samples of earth in contact with the body  Seal it and label it  Take out the body from the grave  Identification by relatives and friends  PM examination  Preserve the visceras

 Following parts should be sent for chemical analysis: -soil -Hair head/pubic hair -nail,teeth -bones -heart -stomach -intestine -liver -spleen -kidney