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COPOS

Medico Legal Importance of Laceration

While physical examination of abrasions is important for treatment, forensic examination of abrasions can be much more meaningful. Abrasions can be present on any part of the body. They are often seen above exposed parts of the body, especially the head and neck, as well as the extremities. If they are above the neck or genitals, they may have a special meaning that requires further evaluation. Figure 15. This pattern wound on the patient`s scalp has wavy features shaped by the teeth of a tube wrench. Acute cervical lacerations bleed and need to be sutured. Cervical lacerations that are not repaired can give a fishmouth appearance to the external functioning system of the cervix; However, they are usually asymptomatic. The use of laminar tents for slow softening and enlargement of the cervix prior to mechanical instrumentation of the endometrial cavity reduced the extent of iatrogenic cervical cuts. In addition, the practice of routine cervical inspection after each birth in the second or third trimester allowed doctors to detect and repair extensive cervical lacerations. Extensive cervical lacerations, especially those affecting the endocervical stroma, can lead to incompetence of the cervix during subsequent pregnancy. Puncture wounds are mechanical wounds in which depth is the greatest dimension in relation to length and width. They can be made with knives, daggers and swords.

The medico-legal aspects of these wounds are as follows: The forensic examination may require a biopsy of the abrasion for histological examination. Histological examination examines the stage of healing in order to estimate the time of injury. Wound healing involves a series of coordinated cellular changes that include bleeding and clotting, inflammatory response, regeneration and remodeling. The regeneration process continues to involve migration and proliferation, while remodeling involves the synthesis of extracellular matrix proteins and collagen, as well as the formation of new parenchymas and connective tissues. These processes are four time-dependent phases: (1) bleeding and coagulation, which begins immediately; (2) Inflammation, even begins without delay; (3) Regeneration, which begins in a few days and lasts during the first part of the acute healing period; and (4) remodeling that begins weeks after injury and can last more than a year. [3] [5] [6] The information can be supplemented by histochemical analyses of inflammatory cells and cellular mediators. This can help inform law enforcement authorities when the violation occurred. The histopathology of an injury can provide important information for a possible examination.

[7] [8] [9] Abrasions occur due to various causes, some are harmless and others extremely serious. Patients and their loved ones should be informed of the medico-legal significance of these seemingly insignificant injuries. Clinicians should also be aware of the importance of documentation. Abrasions in sports can be reduced by protective measures, appropriate padding and clothing, etc. Lacerations are often poorly defined and used, including in health care. Lacerations are not cuts; They are the result of blunt trauma. These are soft tissue defects caused by tearing, tearing, crushing, overstretching, separating or shearing. They have irregular edges that can be scratched or bruised. Often, «bypass» can be observed, which means that the vessels and tissues are not completely torn, but are nevertheless connected by a tissue bridge on either side of the laceration. Lacerations often contain foreign bodies such as glass, dirt and fibers.

Linear abrasions are caused by tangential forces that lead to exposure of the epidermis. Linear abrasions are the simplest wounds and tend to heal by primary intention, without consequences. Linear abrasions have important medico-legal significance, especially when viewed above the neck, inner thighs and genitals. Linear or semicircular injuries are classically thought to be the result of nail scratches, and their presence on the inside of the thighs and around the female genitals may indicate resistance to sexual assault. Similarly, nail scratching abrasions on the neck may indicate strangulation. Firearm injuries include both entry and exit injuries. Injuries vary in shape and size depending on the range of fire, the speed of the projectile and the location of the target. Forensic aspects of firearm injuries include: Lacerations are caused by blunt shocks that tighten and split the skin, or sometimes by shear force. Lacerations most often occur where the underlying bone is prominent – classically at the edge of the orbit.

After treatment, i.e. suturing or gluing, it is often impossible to distinguish between a laceration and an incised wound, which is why sufficient documentation is essential before treatment. The most significant difference that can distinguish lacerations from incised wounds is that incised wounds have clean, distinct edges. Lacerations may have macroscopically clean and distinct edges, but not under magnification. In general, lacerations have irregular or macerated edges – residual skin bypass (especially at the extremities) – and may have other features of blunt lesion, such as swelling, redness and bruising.