Wounds

Dr. Raid Jastania

Wounds

• Blunt force trauma

• Sharp force trauma

• Non-motion trauma

Blunt Force Trauma

• Abrasions:– Scratches and removal of superficial epidermis– Usually do not bleed

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

Blunt Force Trauma

• Laceration:– Splitting of skin due to overstretching blunt

force, usually with full thickness tear– Bleed– Bridging fibers– Ragged edges

Sharp Force Wounds

• Incised wounds (cut):– Sharp cut longer than its depth– Sharp edges– No bridging fibers– Rarely life threatening

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

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”

Pattern of Injury

• Kicking:– By foot– Resulting in bruises, abrasions, lacerations– Common in head, chest, abdomen– Rib fractures

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

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

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

Drowning

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

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…