Incised Wounds And Those Accompanied By Solution Of Continuity





These comprise incised, punctured, and lacerated wounds. In a recent

incised wound inflicted during life there is copious hæmorrhage, the

cellular tissue is filled with blood, the edges of the wound gape and

are everted, and the cavity of the wound is filled with coagula.



Lacerated wounds combine the characters of incised and contused wounds.

They are caused by falls, being ridden over, machinery crushes, bites,

blows from blunt weapons, etc. The wounds heal by suppuration.



Punctured wounds come intermediate between incised and lacerated. They

are greater in depth than in length, being caused by sword or rapier

thrusts. They cause little hæmorrhage externally, but death may be due

to internal hæmorrhage. They may be complicated by (1) the introduction

of septic material adhering to the instrument; (2) the entrance of

foreign bodies which lodge in the wound, not only carrying in septic

matter, but acting as mechanical irritants; (3) injury to deeper parts,

which may at the time be difficult to detect.



An apparently incised wound may be produced by a hard, blunt weapon

over a bone--e.g., shin or cranium. It is often difficult to

distinguish between a wound of the scalp inflicted with a knife and one

made by a blow with a stick. A puncture with a sharp-edged, pointed

knife leaves a fusiform or spindle-shaped wound. A wound from a blow

with a stick might be of this character, or it might present a jagged,

swollen appearance at the margin, with much contusion of the surrounding

tissues. If the wound is seen soon after it is inflicted, examination

with a lens may disclose irregularities of the margins, or little

bridges of connective tissue or vessels running across the wound, and

so be inconsistent with its production by a cutting instrument.

Lacerated wounds as a rule bleed less freely than those which are

incised. Symptoms of concussion would favour the theory of the injury

having been inflicted by a heavy instrument. Again, it is often

difficult to decide whether the injury which caused death was the result

of a blow or a fall. A heavy blow with a stick may at once cause fatal

effusion of blood, but this might equally result from fracture of the

skull resulting from a fall. The wound should be carefully examined for

foreign bodies, such as grit, dirt, or sand. The distinction between

incised wounds inflicted during life and after death is found in the

fact that a wound inflicted during life presents the appearances already

described, whereas in a post-mortem incised wound only a small quantity

of liquid venous blood is effused; the edges are close, yielding,

inelastic; the blood is not effused into the cellular tissue, and there

are no signs of vital reaction. The presence of inflammatory reaction or

pus shows that the wound must have been inflicted some time before

death, probably two or three days.



Self-inflicted wounds are made by the person himself in order to

divert suspicion, or in order to bring accusation against another. Such

wounds are always in front, not over vital organs, and superficial in

character. Note the condition of the clothes in such cases.





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