INCISED WOUNDS-2 MEDICO-LEGAL ASPECTS AGE OF IJURY ANTE-MORTEM NATURE COMPLICATIONS #incisedwounds

​ @DR JAVED IQBAL KHOKHAR LECTURES-FORENSIC MEDICINE YOU CAN FOLLOW ME ON FOLLOWING LINKS ALSO FACEBOOK:   / drjikhokhar   TWITTER:   / drjikhokhar   INSTAGRAM:   / drjikhokhar   #drjikhokhar #drjikhokharlectures MEDICO-LEGAL ASPECTS OF SHARP EDGED INJURIES: 1. Ante-Mortem or Post-Mortem 2. Timing of Injury 3. Manner of Infliction 4. Kind of Weapon Used 5. Complications 1. Ante-Mortem or Post-Mortem Whether injury is Ante-Mortem or Post-Mortem, it will show vital reaction. Like; Hemorrhage, Inflammation. This hemorrhage will stain the tissues. There are signs of healing, repair and inflammation. Ante-Mortem wounds are gapping, due to contraction of underlying tissues. 2. Timing of Injury Gross Examination Color changes, healing & repair. Microscopic Examination Cellular invasion according to time. Biochemical Examination Various Bio-chemicals tests will show enzymes according to time. Enzyme Histo-chemistry Different enzymes also shows concentration according to time. Naked Eye Examination When it is Fresh, there is hemorrhage. Up-to 2 hours, Edges are Red & Swollen and Blood & Lymph are adherent to edges. There is Neutrophilic infiltration. By 24 hours, there is continuous layer of epithelial cells. This epithelium covers the wound and above it a scab is formed. In 36 hours, a capillary network is completed. In 48-72 hours, there is epidermal invasion. In 3-5 Days, collagen fibers invade, they develop parallel to blood vessels. In 1-2 weeks, Scar Formation starts. 3. Manner of Infliction Accidental: Homicidal: Suicidal: Usually it is Accidental & Homicidal. Self inflicted lacerations are not seen. Examination of scene of crime, circumstantial evidence & examination of injury will decide. The identification of being homicidal or suicidal is based upon situation, character and circumstances. Generally the presence of incised wounds indicates the intent and they should be described carefully. Manner of Infliction Suicidal: Suicidal are always present on accessible parts of the body. Incised wounds with hesitation cuts indicates suicidal in nature and without hesitation cuts may be homicidal. Manner of Infliction Cut Throat: Wrist Injuries Light Sharp Edged Weapon, Manner of Infliction like: Knife is used and sometimes Razor is used. Homicidal: Homicidal wounds may be on any part of the body. Sometimes they are Heavy Sharp Edged Weapons. Homicidal: In homicidal assaults, this may sometimes indicate the relative position of the assailant and victim Accidental: Accidental wounds are on any part of the body. Besides other injuries these can occur due to Road Side Accidents, if some sharp object is involved And they also occur due to household work by Knife or any other Sharp Edged Instrument. Medico-Legal Aspects of Incised wound Manner of infliction Therapeutic Autopsy (Post-Mortem Cutting) Self inflicted (Fabricated) Surgical Incisions Surgical Incisions are recognized by their Location, Direction and Hospital Notes. Laproatomy Incision Tracheostomy Incision Autopsy Incisions Autopsy Incisions are also on elective site. There are specific incisions for opening the body cavities. Autopsy Incisions They are Post-Mortem cuts and there will be no Vital Reaction. 4. Kind of Weapon Used Lacerations have No Shape, irregular but sometimes, They are. Blow with Linear object produces Y-Shaped Laceration with splitting at one end. If impact is by an object which is Blunt & Square, like; Hammer produces Crescenteric laceration. If weapon is Blunt & Round, Stellate shaped laceration is produced. Sometimes the shape and features of injury can help in identifying the shape of the weapon If the incised wounds are made by curved weapons, such as: Sickle The pointed end of the instrument may make a stab or puncture and the blade a cut wound Sometimes it has got an area of un-touched skin in between. If the blade has serrated edge instead of cutting edge, it will cause laceration Wounds from jagged portion of metal or pieces of broken glass have nature of incised wound But are usually irregular and the edges of such wounds are generally bruised Patho-Physiological Effects / Complications Early Complications Delayed Complications Early Complications Hemorrhagic Shock Injury to Vital Organs Early Complications As incised wounds are open wounds, and the vessels are cut the bleeding is externally and profuse. Early Complications Sometimes bleeding is extensive and leads to Shock and may be Fatal. Delayed Complications Infections: Septicemia Early Complications Sometimes bleeding is extensive and leads to Shock and may be Fatal.