PATHOLOGY OF WOUNDS

ATTY. PETE MALINAO, MD

MEDICO-LEGAL
 DEFINITION
PRESENTATION

OF WOUND
TITLE

DAMAGE TO ANY
PART OF THE BODY
DUE TO
MECHANICAL
FORCE
2
 MECHANISM OF WOUNDING
PRESENTATION

• The intensity of the force obeys the usual laws of

TITLE

physics
• The force varies directly with the mass of the
weapon and directly with the square of velocity of
impact.
• Kinetic energy = ½ mass x velocity²
• The effect of excessive mechanical forces on the
tissues of the body can cause compression, traction,
3 torsion or tangential (shear) and leverage stress.
 GENERAL STRUCTURE OF THE SKIN
PRESENTATION
TITLE

4
 TYPES OF INJURY TO THE SKIN
PRESENTATION
TITLE

5
 CLASSIFICATION OF
PRESENTATION

WOUNDS
TITLE

ABRASION
• THE MOST SUPERFICIAL OF
INJUIRES AND IS ONE THAT
DOES NOT PENETRATE THE
FULL THICKNESS OF THE
EPIDERMIS
• CAUSE BY ANY CONTACT
THAT RUBS ACROSS THE
EPIDERMIS AND REMOVES
THE KERATINIZED LAYER OF
THE SKIN
• SCRATHES OR GRAZES
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 TANGENTIAL
PRESENTATION

OR BRUSH
TITLE

ABRASION

THE DIRECTION OF
FORCE CAN OFTEN BE
DETERMINED BY TAGS
OF EPIDERMIS
DRAGGED TO THE
TERMINAL END OF THE
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ABRASION
TANGENTIAL OR BRUSH
ABRASION
 TANGENTIAL OR BRUSH
ABRASION

CAUSED BY CONTACT OF A MOVING BODY WITH ROUGH

SURFACE
FINGERNAIL ABRASION

THE SMALLER MARKS ARE FINGERNAIL SCRATHCES

 PATTERNED ABRASION

PATTERNED ABRASION FROM THE BACK EDGE OF A SERRATED “RAMBO KNIFE”

 CONTUSIONS
PRESENTATION

OR BRUISES
TITLE

• EXTRAVASCULAR
COLLECTION OF BLOOD
THAT HAS LEAKED FROM
THE BLOOD VESSELS
DAMAGED BY
MECHANICAL IMPACT

• CAUSE BY DAMAGE TO
12 VEINS, VENULES AND
SMALL ARTERIES
 FACTORS AFFECTING THE
PRESENTATION

PROMINENCE OF BRUISE
• SUFFICIENT SPACE OUTSIDE THE BLOOD VESSEL FOR FREE
TITLE

BLOOD TO ACCUMULATE
• RESLIENT AREAS (ABDOMINAL WALL AND BUTTOCKS)
• THE DEPTH AT WHICH THE BRUISE IS PLACED AFFECTS THE
APPARENT SEVERITY
• FRAGILITY OF BLOOD VESSELS AND COAGUBILITY OF THE
BLOOD
• CONTINUED BLEEDING FROM RUPTURED BLOOD VESSELS,
PERCOLATION OR HEMOLYSIS

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BRUISING WITH SPECIAL SIGNIFICANCE

SIX PENNY BRUISES

BRUISING WITH SPECIAL SIGNIFICANCE

THE CENTER COMPRESSES THE SKIN, WHICH IN THE ABSENCE OF UNDERLYING BONE,
CAUSES LITTLE OR NO DAMAGE TO THE BLOOD VESSELS. WHEN THE MOMENTARY
IMPACT IS RELEASED, BLOOD FLOWS BACK INTO THE MARGINAL ZONE AND LEAKS INTO
THE TISSUE
BRUISING WITH SPECIAL SIGNIFICANCE

SHOWER OF PETECHIAL LESIONS CAUSED BY ORAL SUCTION ON THE SKIN. “LOVE BITES”.
PRESENTATION

LACERATION
TITLE

• CAUSED BY BLUNT
INJURY IN WHICH THE
FULL THICKNESS OF THE
SKIN IS PENETRATED.

• THE CONTINUITY OF THE

TISSUES IS DISRUPTED
BY TEARING RATHER

17 THAN CLEAN SLICING

 LACERATED WOUND

LACERATION OF THE SCALP FROM BLUNT WEAPON, A METAL BAR.

 LACERATED WOUND

THE WOUND IS STELLATE AS A RESULT OF CRUSHING AGAINST AN UNDERLYING

BONE. THE FICTIM FELL DOWNSTAIR SUSTAINING SPINAL CORD INJURY.
THE SKIN IS SANDWHICH BETWEEN WEAPON AND BONE AND THIS CAUSED LACERATED
SPLIT THAT HAS BRUISED MARGINS AND BRIDGES OF HAIR AND TISSUE IN THE WOUND.
 INCISED
PRESENTATION

WOUND
TITLE

• CAUSED BY SHARP
OBJECTS

• CLEAN DIVISION OF SKIN

AND UNDERLYING
TISSUES SO THAT THE
MARGINS ARE ALMOST
FREE FROM ANY
DAMAGES.
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 CUTS OR
PRESENTATION

SLASHES
TITLE

• WHEN THE INCISED WOUND

IS LONGER THAN IT IS DEEP.

• SEEN WHEN THE ASSAILANT

STRIKES OUT WITH A
SWUPING ACTION RATHER
THAN THRUST OF STABBING
ATTACK

• ALSO SEEN IN SUICIDAL

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INJURIES
 STAB WOUND
PRESENTATION
TITLE

• AN INCISED WOUND THAT IS

DEEPER THAN IT IS WIDE

• THOUGH MANY PENETRATE

ONLY THE SKIN AND
SUBCUTANEOUS TISSUES,
THOSE SEEN BY FORENSIC
PATHOLOGIST ARE MOST
OFTEN FATAL.

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 NATURE OF STABBING WEAPON
PRESENTATION

• THE LENGTH WIDTH AND THICKNESS OF THE BLADE

TITLE

• WHETER SINGLE OR DOUBLE EDGE

• THE DEGREE OF TAPER FROM TIP TO HILT
• NATURE OF THE BACK EDGE IN SINGLE-EDGE KNIFE
• FACE OF HILT GUARD ADJACENT TO THE BLADE
• ANY GROOVING, SERRATION OR FORKING OF THE
BLADE
• SHARPNESS OF THE EDGE AND TIP OF THE BLADE
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 CHARACTERISTICS OF A STAB
WOUND
PRESENTATION

WHICH WOULD ALLOW THE PATHOLOGIST TO OFFER AN

• DIMENSION OF THE WEAPON
OPINION UPON
TITLE

• TYPE OF WEAPON
• THE TAPER OF THE BLADE
• MOVEMENT OF THE KNIFE IN THE WOUND
• THE DEPTH AND THRUST
• THE DIRECTION OF THRUST
• THE AMOUNT OF FORCE USED

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 DIMENSIONS OF
PRESENTATION

THE WEAPON
TITLE

• THE LENGTH OF WOUND

SHOULD BE MEASURED TO
THE NEAREST MILLIMETER
AS IT LIES UNDISTURBED IN
THE SKIN.

• AND SHOULD BE MEASURED

AGAIN WHEN THE EDGES
ARE GENTLY OPPOSED

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STAB WOUND, ONE-EDGED BLADE

THE WOUND HAS A SHARPER LOWER EDGE COMPARED TO ROUNDER UPPER EDGE.
STAB WOUND, BLUNT BACK EDGE

MINUTE BILATERAL “FISH-TAIL” SPLIT CAUSED BY BLUNT EDGE OF KNIFE BLADE

DEPTH OF THE THRUST
 DEFENSE
PRESENTATION

WOUND
TITLE

• IN ASSAULTS OF ANY KIND,

THE NATURAL REACTION OF
THE VICTIM IS TO PROTECT
THEMSELVES

• MEDICOLEGAL SIGNIFICANT
AS IT MAY INDICATE THAT
THE VICTIM WAS
CONSCIOUS AND NOT TAKEN
COMPLETELY BY SURPRISE
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DEFENSE INJURY FROM KNIFE
THANK YOU