Wounds / Injuries

INTRODUCTION

A wound is any damage or break in the surface of the skin.

Production of wound: A wound is produced when the intensity of the applied force to the body exceeds the capability of the tissue to adapt or resist the force.

According to section 44 of Indian Panel Code “An injury is define as any harm, whatever illegally caused to any person in body, mind, reputation or property.”

Classification of Injuries

Depending upon Medical
•Mechanical
•Thermal
•Chemical
•Physical
•Explosions

Mechanical Injuries
Due to Blunt Force
– Abrasions
– Bruises/ Contusions
– Lacerations
– Fracture and dislocations
• Due to Sharp Force
– Incised wounds
– Chop wounds
– Stab Wounds
• Due to Firearms

Thermal Injuries
•Due to Cold
–Frostbite
–Trench Foot
–Immersion Foot
•Due to Heat
–Burns
–Scalds

Physical
Electricity
-Lightening
-X-Rays
-Radioactive material

Depending upon Gravity (Legal)
Simple Injury
-Grievous Injury

Depending upon time of Infliction
Antemortem
-Postmortem
-Perimortem

Depending upon the manner of Inflcition
Suicidal
• Homicidal
• Accidental
• Defence wounds
• Self-inflicted/ self suffered
• Fabricated Fictitious injuries


CAUSES OF WOUNDS

MECHANICAL AGENTS

Wound can be caused by mechanical forces having an impact on A tissue. When A mechanical force acts on A tissue and causes. Lacerations and contusions are examples of mechanical injury inflicted on A living tissue.

CHEMICAL AGENTS

Chemical agents can cause tissue wounds by necrosis of the skin such as in snake bites, burns of the skin due to acids or by strictures of the esophagus as a result of drinking concentrated alkalis especially in children (a common household accident).

Radiant agents of tissue injury

Radiation could be in various forms such as X-rays, atomic energy, heat, high voltage electricity and intense cold.

Pathogenic Microorganisms

The pathogens make use of chemicals known as toxins which help to dissolve tissue and can cause hypersensitivity reactions. These organisms do not directly cause wound but invade an already existing wound.

TYPES OF INJURIES/WOUNDS AND THEIR PHYSICAL CHARACTERISTICS

Types of Wounds
  1. Open wounds
  2. Closed wounds
  3. Contusion (Bruise)
  4. Laceration
  5. Avulsions
  6. Punctures
  7. Penetration
Open wounds

These are wounds in which there is loss of superficial surface covering the tissue such as loss of skin.

Closed Wounds

These are wounds that occur without a loss of superficial surface covering the wound. The wound occur under the surface of the skin without affecting the skin. An example of this type of wound is contusion. Infection of these wounds is rare and it may resolve without any treatment if it is not extensive.

Abrasions

In this type of injuries the skin in which the outer layer of the skin is scarped off. Examples of the abrasions are scratches, grazing of the skin caused by dragging, imprint caused by belt/hunter/ sticks.

Contusions/Bruises

This type of injuries occurs when blood vessels in the skin or internal organ are ruptured. A bruise heals by destruction and removal of the extravasated blood.

LACERATIONS

Lacerations are tears or splits of skin, mucous membranes, muscle or internal organs produced by application of blunt force or broad are of the body. Types of lacerations are split lacerations (crushing of the skin between two hard objects), stretch lacerations (overstretching of skin), avulsion, tears etc.

Sharp Force Injury

These are caused by cutting or stabbing the skin with sharp instruments/weapons such as knives, swords, tins, broken glass bottles, razor blade and tools.

a) Incised/cuts Injury: This type of wound is a superficial injury in which the size of the injuries on the surface is larger than the depth.

b) Stab or Penetrating Injury- This type of injury is produced from the penetration of pointed or sharp weapons on to the depth of the body that is deeper than its length, generally knives.

Firearms Injury

They are usually recognized without difficulty. The injuries produced by fire arms vary depending on the projectile, the muzzle velocity, distance, angle of firing and part of the body involved. These wound are subdivided as, when a bullet, passing through a body, produces a wound. the point of entrance on the skin known as ENTRY WOUND and another at the point of exit of the bullet known as EXIT WOUND.

Fracture

 It is the breach of continuity of bone or tooth caused by application of blunt force. Clinical features and X-ray findings are considered to diagnose this type of lesion. In dislocation of joint the bone ends get displaced completely from their normal anatomical positions with damage to the adjacent tissues.

Incised wound

 It is caused by the sharp edge of the weapon applied to the skin perpendicularly or obliquely making regular clean edges of the wound. It is called a slash wound when the length of the wound is greater than its depth.

Blast wounds

These are produced by explosion of bombs and are due to blast pressure wave (shock wave), blast winds, heat, splinters, shrapnels, surrounding small fragments propelled by blast winds.

Burns

Burns are caused by flame, heated objects and scalds by hot liquids and vapours or gases.

Bodily harm may also be caused by corrosives, electricity, insecticide, high dose of drugs.

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