MECHANICAL WOUNDS

(DIFFERENT TYPES AND THEIR DESCRIPTION

WITH EXAMPLES)

Name Praloy barman

Roll Number - 146

Year- 3rd

Subject- FORENSIC MEDICINE AND TOXCOLOGY

College - KPC MEDICAL COLLEGE AND HOSPITAL

ACKNOWLEDGEMENT

I would like to thank our HOD and also the

other professors of the department of Forensic
Medicine and Toxicology of my college for
giving me the opportunity to learn about the
topic mechanical wounds and make a project
on it. I would also like to thank them for all
their help to complete this project

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Injury

• What is an injury?
• An injury is any physiological damage to living tissue caused
by immediate physical stress. It can occur intentionally or
unintentionally and may be caused my blunt trauma,
penetrating trauma, burning, toxic exposure, asphyxiation,
or overexertion. Injuries can occur in any part of the body,
and different symptoms are associated with different
injuries.

• What is a mechanical injury?

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 • Mechanical wounds, also known as mechanical injuries,
are injuries that result from direct physical contact or force
applied to the body.
• They can occur in various settings, such as accidents,
sports activities, or deliberate actions.

• TYPES OF MECHANICAL WOUNDS

• Mechanical wounds can be classified into several types,

including abrasions, bruises, and lacerations, incised
wound, stab wound, firearm wound and fracture

• ABRASION

• An abrasion, also known as a scrape or graze, is a

superficial wound that occurs when the outer layer of the
skin (epidermis) is damaged or rubbed off due to friction
against a rough surface.

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 • Common causes of abrasions include falls on abrasive
surfaces, contact sports, or accidents involving scraping
against rough objects.

• Abrasions typically result in a painful, raw area with oozing

of serum or blood.

• They can vary in size and may take some time to heal,
forming a scab during the process.

TYPES OF ABRASION

1. Scratch abrasion [Simplest abrasion]

• Produced by Pin, Thorn, Nail etc

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2. Grazed abrasion
• MC seen among Road traffic accidents
• Occurs when skin is rubbed against the rough surface
• Multiple scratches over wide area are seen
• It is most common type of Abrasion
• also called Gravel rash/Brush burn/ Sliding abrasion / Scraping

3. Pressure Abrasion
• Crushing of the epithelium is seen due to continuous
application of pressure perpendicularly
• E.g. Ligature mark, Bite mark

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4. Patterned abrasion (Imprint abrasion)
• Crushing of epithelium by perpendicular pressure + Pattern of
weapon imprinted on the skin are seen
. E.g.: Radiator grill mark, Tyre mark, Ligature mark [sometimes]
Ligature mark [pattern of ligature mark is seen]: Patterned
Abrasion

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Medical importance
On examining an abrasion, we can find
• Direction of force
o Head end is broad & tail end is narrow
o Scraped epithelium is collected at tail end of abrasion
called as Epithelial tag/Heaping of epithelium
• Ageing of Abrasion
o It is based on the healing pattern & colour of the scab
o Any abrasion heals within 1 week
o During this 1 week, scab [dried lymph] keeps on changing its
colour
After a week, scab falls off leaving a hypo-pigmented
area
o When Road traffic accident Patient comes to the casualty &
says that he had met with an accident 3days back.
Examine the pt. → If the abrasion is raw & reddish, it means
abrasion was sustained just recently. Thus, history doesn't
correlate with the findings → It indicates that the pt. is telling
lie
• Manner of the death
o Depends on the location & distribution of the abrasion
over neck
1. Peri-oral abrasions -Smothering

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 2. Multiple grazes all over the body -Road Traffic Accident
[RTA]
3. Genital abrasion -Sexual assault

• D/D of Antemortem abrasions

• Antemortem bite marks.
• Excoriations
• Post-mortem abrasions
o MC located at bony prominences
o Inflammatory/Vital reaction is absent
• Medically, the most significant wound is Abrasion

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BRUISE
• A bruise, also referred to as a contusion or hematoma,
occurs when small blood vessels near the skin's surface
rupture, leading to the collection of blood beneath the
skin.
• Bruises are typically caused by blunt force trauma, such as
a blow, impact, or compression to the body.
• The skin over a bruise appears discolored, often with
shades of blue, purple, or black, due to the presence of
trapped blood.

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 • Bruises can be painful and may change color as the body
reabsorbs the blood over time. They usually resolve within
a couple of weeks
• Margins are irregular

Factors influencing the development of

bruise
1. Site
At some sites, smaller force can produce severe
bruising • E.g.
o At Bony Prominences
o Loose tissue like scrotum, eyelids etc
At some sites, higher force can produce less bruising •
Eg: Thicker tissues like palm, soles etc

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 2. Age
• In children & elderly (two extremes of ages), minimal
force
can cause severe bruising due to delicate subcutaneous
tissue

3. Sex
• Females tend to bruise more easily than males [due to
nature of subcutaneous tissue]
4. Complexion
• Bruises are clearly visible in ppl with Fairer complexion
• In dark complexion, contusion isn't clearly visible.

CLASSIFICATION OF BRUISES, BASED ON

THEIR LOCATION
• Intradermal bruise:Bruise is close to Dermo-
epidermal junction
• Subcutaneous bruise
• Deep bruise: Bruise is deeper to muscle planes
o Deep bruise might come out after half a day called as
Come-out bruise/Delayed bruise

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 SPECIAL TYPES
1. Ectopic bruise/Migratory bruise
If a bruise develops at another site, other than the site
of the impact, it is called as Ectopic or Migratory bruise
[i.e blood migrates]
Eg
o Black eye
Impact is at frontal region. But contusion is seen at Peri-
orbital region

o Battle's sign
→ Post-auricular ecchymosis [Ecchymosis is seen at
mastoid area]

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 → Classically seen in Middle Cranial Fossa fracture

2. Patterned Bruise
• Suggests the pattern of the weapon
. E.g.
o Six Penny bruise
→ Shape & size of bruise looks like six penny coins.
→ This bruise is d/t pressure of fingertips
→ Discoid/ round bruise is seen over the neck. It is
classical to Throttling/Manual strangulation
→ It is also seen in Battered Baby syndrome
Pressure of finger tips

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 o Butterfly bruise
→ Shape of the bruise looks like wing of the butterfly
→ Classically seen d/t skin pinching
→ Seen in Battered Baby syndrome/ Child abuse

o Tram line Bruise (aka Railway line bruise)

→Any weapon which is longitudinal like stick, Cane,
Lathi can produce this bruise
→This bruise looks like Tram-line/ Railway-line. Hence,
k/a Tram line Bruise/ Railway line bruise
→ These patterns help us in identifying the weapon
causing it

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 3. Artificial bruise [Fake bruise]
• Produced by application of plant juices like
o Marking nut
o Calotropis
o Plumbago etc
• These juices are highly inflammatory
When these juices are applied over skin, blisters are
formed d/t inflammation
• Features of Artificial bruise
o Well-defined
o Regular margins
o Blisters

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 o Acrid serum [inflammatory fluid present in the
blisters] o Itching
o Usually located at accessible parts of the body
By the above features, it is differentiated from true
bruise

2. Ageing of Contusion
. As the contusion is healing, color of contusion changes
. Thus, ageing of contusion is determined by color
change of contusion

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 • Color of contusion depends upon the pigment inside

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LACERATION
• Lacere means to Tear
• A laceration is a deep, irregular wound with jagged or
torn edges that occur when the skin and underlying
tissues are cut or torn apart.
• Lacerations can be caused by sharp objects, such as
knives, broken glass, or tools, as well as by blunt force
trauma.
• The severity of lacerations can vary, ranging from
superficial cuts to deep wounds that involve muscles,
tendons, or organs.
• Depending on the depth and location, lacerations
may require medical attention, stitches, or surgical
intervention for proper healing

Features
• Irregular margins with contused edges
• At Floor: all the structures [Vessels /Nerves/ Hair bulb] are
Crushed

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 • Tissue bridges: Tissue fragments connecting both the
edges [confirms the diagnosis]
• Swallow tail: small split from the edge of the laceration

TYPES OF LACERATION
1. Split Laceration
• Aka Incised looking laceration
• Sites involved are Bony prominences [i.e., skin is close to
the bone & subcutaneous tissue is minimal]
o Pre-tibial region/Shin

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o Scalp
o Forehead
o Zygoma
o Iliac crest
o Posterior aspect of the elbow etc.
.When examined with a naked eye: margins look regular
• When examined with magnifying lens: Irregular margins
& crushing of structures at floor are seen
• Has Medico-legal importance

2. Stretch Laceration
• Seen d/t overstretching of the skin

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• Occurs when heavy force is delivered into the skin at Acute
angle
• Flapping is seen
• When a person is kicked, force is delivered at an angle
resulting in Stretch laceration
• In Compound fracture, where bony fragments come out,
stretch laceration is seen

3. Avulsion Laceration/Grinding laceration

• Occurs due to Rotational Force also called as Run Over Injury
running on the body part
Flaying [which is flap coming out due to rotational force] is seen

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4. Cut Laceration
• Occurs d/t combination of blunt & sharp force (looks like
Chop injury)
• Caused by Heavy weapon with sharp edge. Eg: Axe
Edges of the wound are Bruised & crushed
Underlying tissues are crushed
• Underlying bone is fractured

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5. Tear Laceration
• Simple tearing of skin is seen
• E.g.: Laceration d/t impact with doorknob

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CONCLUSION

Other types of mechanical injuries include puncture

wounds (resulting from a sharp, pointed object
penetrating the skin), avulsions (where a portion of
skin or tissue is forcibly torn away), fractures
(broken bones resulting from excessive force), and
crush injuries (caused by compression or crushing of
body parts).
It's important to note that the classification and
terminology of mechanical injuries may vary slightly
in different medical and legal contexts. Proper
evaluation, diagnosis, and treatment of these
injuries should be carried out by healthcare
professionals to ensure appropriate care and
recovery.

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