Wounds
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Transcript of Wounds
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Wounds
Dr. Raid Jastania
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Wounds
• Blunt force trauma
• Sharp force trauma
• Non-motion trauma
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Blunt Force Trauma
• Abrasions:– Scratches and removal of superficial epidermis– Usually do not bleed
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Blunt Force Trauma
• Contusions:– Bruises– Blunt trauma with rupture of blood vessels with
leakage of blood into surrounding tissue– Color: blue/dark blue/purple/green/yellow– In adults, usually resolve by 1 week– If yellow >18 hours
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Blunt Force Trauma
• Laceration:– Splitting of skin due to overstretching blunt
force, usually with full thickness tear– Bleed– Bridging fibers– Ragged edges
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Sharp Force Wounds
• Incised wounds (cut):– Sharp cut longer than its depth– Sharp edges– No bridging fibers– Rarely life threatening
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Sharp Force Wounds
• Stab wounds– Cut deeper than its length– Often fatal– Common in homicide– Weapon shape and size
• Knives with one sharp edge and one blunt edge
• Depth of injury can be longer than the weapon
• May be surrounded by bruising and abrasions
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Pattern of Injury
• Punching:– Blow by clenched fist– Usually in skin close to bone– Resulting in bruises, abrasions– Laceration of skin edge eg. Eyebrow, cheek,
lips– Bruises of face, periorbital hematoma “black
eyes”
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Pattern of Injury
• Kicking:– By foot– Resulting in bruises, abrasions, lacerations– Common in head, chest, abdomen– Rib fractures
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Pattern of Injury
• Bite marks– Bruises and laceration– Seen in sexual assault: neck, breast, shoulder– Seen in child abuse: arms, buttocks– Pair of curved lines of bruises
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Pattern of Injury
• Defense injury:– Defense against blunt weapon attack:
• Bruises of forearm (ulnar side)
– Defense against sharp weapon attack:• Incised wounds on palm, and forearm
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Pattern of Injury
• Self-inflicted injury– Bites: on medial aspect of arm– Incised wounds
• “elective sites”: front of wrist, and neck
– Stab wounds• Abdomen
– Hesitation injury– Sites not injured: eyes, lips, nipples, genitalia
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Drowning
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Drowning
• Not simple hypoxia• Entry of water into lungs• Fresh water is hypotonic
– Enters lungs – water diffuse to vascular space – by osmosis – increase in blood volume upto 50% in one minute + hemolysis of blood
• Seawater is hypertonic– Enters lungs – fluid is shifted from vessels to alveolar
space – longer suvival
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Drowning
• Post mortem findings:– Frothy fluid in nose and mouth, trachea and
lungs– Lungs sink in water– “dry lung drowning”– Finding of Diatom in lungs, and distal organs,
brain, kidneys…
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