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Assoc. Prof. Beatrice Ioan MD, PhD, MA
Definition- damage to the tissues of the body caused by a mechanical force Damaging agents: - Mechanical - Physical - Chemical - Biological - Psychical, psychological
I. Intact skin - Traumatic eritema - Bruise (contusion) - Hematoma
II. Injured skin - Abrasion (scratch, graze) - Wounds
• produced by a light slap or a continuous pressure against the tissues • transient irritation of the nervous endingsdilatation of the vessels • pain, redness of the skin/ red points on the skin, tumefaction • all signs and simptoms dissapear in a few hours
hammer.Damage of the small and middle blood vessels beneath the skin.Possible deep bruising. fist.any organ.Most frequent under the skin . stick. club. leg .Blunt injury to the tissue.Bruise/contusion .the blood leaks into the surrounding tissues . tissue .strike or compression Blunt objects: rock.
the blood leaks in a diffuse manner Bruise changes with time and position .The bruise may become visible at a later moment from the trauma .The bruise may appear at a different site than the injury site .Bruise/contusion .Usually it does not reproduce the pattern of the causative object.repeated examinations .
Bruise/contusion Timing → colour changes Chemical changes of hemoglobin • the first hours.green-yellow (biliverdin) • 7-8 days.brownish (hemosiderin) • 7-20 days. .yellow.red (HbO2) • few hours.bluish (reduced Hb) • 3-5 days.normal skin colour (depend on the size and depth of the bruise).
Bruise/contusion The speed of the changes is very variable7-10 days Recognition of bruises of different colours in the same person.child/adult abuse Differentiated from postmortem lividities .inflicted at different times.repeated aggressions.
Size • space outside the vessels for free blood to accumulate. depending on: * the intensity of the traumatism. * the size and the density of the vascular network in the damaged region. • fragility of blood vessels.Bruise/contusion . • presence of the bone directly under the skin. • depth of blood accumulation. • coagulability of the blood . • gravity of the bleeding.
Envelope imprint .Bilateral ovalar bruises on the throat.Bruise/contusion Particular types of causation.“Tram-line”/”railway-line .manual strangulation .mark bruises .
two parallel lines of bruising with a pale undamaged area between.rod-like weapon.“Tram-line”/”railway-line” . either cylindrical or square-sectioned .
an important collection of blood. • hematomas in the natural cavities or inside the organs have. • May determine compresion of the muscles.the rupture of a big vessel. organs. natural cavities • Superficial hematoma. nerves.Hematoma Definition. vessels. a severe evolutioneven death . frequently.the covering skin is bruised.surgical treatment to evacuate the blood.blunt injury Localization: tissues.
crushed injury Two possibilities: .Abrasion .vertical impact.The body hits a stationary object (fall) .An object strikes the skin (a bite from a tooth) . . determining the abrasion of the superficial layers.The most superficial type of injury which destroys the integrity of the skin Mechanism: .Less often.Friction of a sharp or irregular object against the surface of the skin.
g. excoriated area .no bleeding .reddened.Some abrasions enter the dermis.Abrasion .multiple parallel linear abrasions When the skin is protected by clothing“friction burn”.slight bleeding (dermal papillae) Shape: .Linear .Usualy confined to epidermis..Broader.brush abrasion E. dragging across a rough road in traffic accidents.
crust (yellow or redishbrownish).dissapears without any traces .Abrasion Evolution • the first 12. • 7-8 days.a white track on the skin .24 hours.the crust begins to detach. • 3-4 days.
child abuse) .Fingernail abrasions . .curved /on the neck.the finger are dragged down the skin (sexual attacks.strangulation by hand.linear abrasions.
usually when the impact is vertical to the surface of the skin (crushing abrasion). .abrasion .Marker.
thin.Draging .linear. parallel abrasions .direction of the force causing the abrasion.the torn epidermis will be pulled towards the distal (final) end of the abrasion .close examination.
Penetrates the full thickness of the skin .Blunt injury.crushes the tissues .Laceration .
crushed tissues. • persistance of tissue strands across the interior of the wound. • bruises and abrasions in the surrounding tissues. • the hair is not destroyed / may be crushed. • blood infiltration in the edges.infection . small pieces from the clothes. • main complication. dirt. • content. clots of blood.characteristics • irregular edges.Laceration.
scalp. • the margins are regular.e.the crack wound presents tissue strands across the margins .g. sharp.particular types Crack wound • the skin is compressed between the bone and the blunt object. • must be differentiated from the cut wounds .injuries in the surrounding tissues .Laceration.
Bite wound .identification of the aggressor .samples of saliva.preserve the shape of the teeth .
screw driver (pricking object) Characteristics Entry wound • on the skin/mucosal surface • a red point if the weapon’s diameter is small (sharp needle) or a small wound with sharp edges if the weapon’s diameter is bigger .needle.Pricking wound Mechanism Lateral compression of the tissues by a thin object with acute point.
Pricking wound Channel • in the depth of the tissues Exit wound • rare • the damaged part of the body is small/thin • the weapon is long enough .
Pricking wound Complications • severe. pericardium) • death.g. even lethal bleeding when blood accumulates inside a natural cavity (e.when the heart or fontanel (infanticide) are damaged .
usually linear. an organ (nose) or a part of a limb .Sharply cut injuries .larger than deeper.Produced by objects with at least one cutting edgepressure and movement of a sharp edged object against the tissues Classification • cuts (slashes).the cut is oblique. • complete section of a part of tissue.Cut wounds . • partial detachment of the tissues.
• the cut is deeper at the entry. • surrounding tissues. becomes progressively shallower as the wound approaches the distal end → linear abrasion .Cut wounds .intact.characteristics • regular edges.blood (liquid or clots).bleeding . • main complication.mouse tail • content. • no tissue strands in the interior of the wound. • the hair is divided.
• active defence.Cut wounds Defence wounds • passive defence. .cuts on the palms (the victim tryes to catch the knife).cuts on the dorsal part of the hands and forearms.
one cutting edge .Stab wound Mechanism: pricking and cutting the tissues.two cutting edges * triangle. by an object with acute point and sharp edge/edges Characteristics Entry wound • on the skin. • characteristics of a cut wound. is possible to determine if the knife has one or more cutting edges edges * buttonhole. • according to its aspect.
Exit wound • characteristics of a cut wound According to the aspect of the entry wound and channel is possible to estimate the dimensions of the knife in the cavities with a bony wall .Stab wound Channel • In the depth of the tissues • its direction shows the weapon’s direction inside the tissues.
Damages in the vital organs .axe. heavy sword Appearance .danger for life .Bone fractures .combination between cut wound on the surface of the skin and laceration in depth Frequent .Split wound Mechanism: heavy objects with a sharp edge. hoe.
ends .Description of injuries • Location • Dimensions • Shape • Direction • Aspect .abrasion – crust .bruise – colour .wound .margins .surrounding tissues .content .stage of healing .
Wounds .forensic relevance • The damaging weapon → marker injury • Producing mechanism .colour .bruises and abrasions on the neck – strangulation by hand/ligature • Date of the trauma .injuries located on the prominent parts of the body → fall .aspect of the crust .abrasions .wounds – stage of the healing – aspect of the scar .bruise .