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Wounds

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

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Wounds

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  1. Wounds Dr. Raid Jastania

  2. Wounds • Blunt force trauma • Sharp force trauma • Non-motion trauma

  3. Blunt Force Trauma • Abrasions: • Scratches and removal of superficial epidermis • Usually do not bleed

  4. 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

  5. Blunt Force Trauma • Laceration: • Splitting of skin due to overstretching blunt force, usually with full thickness tear • Bleed • Bridging fibers • Ragged edges

  6. Sharp Force Wounds • Incised wounds (cut): • Sharp cut longer than its depth • Sharp edges • No bridging fibers • Rarely life threatening

  7. 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

  8. 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”

  9. Pattern of Injury • Kicking: • By foot • Resulting in bruises, abrasions, lacerations • Common in head, chest, abdomen • Rib fractures

  10. 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

  11. 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

  12. 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

  13. Drowning

  14. 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

  15. 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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