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Medico-legal importance of abrasions, bruises, contused

wounds: vista: visda


Abr asions Bruise s Con tuse d
Wound s
V: violence evidence of violence evidence of violence evid en ce of vi ol enc e

I: causative By shape: By shape: Ra re evi de nc e


Fingernail abrasions. Longitudinal line: ha rd
instrument
Teeth abrasions. st ic k.
Car radiator abrasions. 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 .
S: site Give idea about type of Give idea about type of Ra re evi de nc e.
crime: crime:
Finger nail around neck: Bruises on neck: throt tl in g.
th rott li ng
Fingernails on inner side
of thighs: rap e.
D: danger Rarely cause death. Only if: Wi th :
Extensive. S ep si s.
Infected. D isfi gur in g sca rs.
With internal hge. In tern al h ge .
differentiate
Cut& contused wounds. Cut& contused wounds.
Homicidal& suicidal + it must be differentiated Hom ic ida l& s uic id al
wounds. from Hyptosis Pg. 54 wou nds ra re ly
Hyptosis& bruises. su ic ida l
+ i t mus t b e
+ direction of tangential dif fer en tia ted fr om
abrasions: in ci se d w ou nds :
Starting edge. Ab ra si on s&
Parallel furrows. bru is es.
Terminal epidermal tag. R agge d edg es .
Com pr es sed
bas e
wi th t is su e
bri dg es .
A: age 1 st da y: cov er of d ry 1 st da y: r ed (oxy Hb) .
sca b. 1-3 da ys: b lu e
> 3 d ays: d ry b rown (r ed uced Hb ).
sca b. 4-5 da ys: g re en
> 1 wee k: scab fa ll s (b il iver di n) .
l eavi ng r ed 5-1 0 da ys: yel low
ar ea . (b il iru bi n) .
> 2 wee ks: r ed a re a 2-3 week s: he al s.
d is app ea rs (n o
sca rs).
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.