7 - Wounds Part4

7 - Wounds Part4 - By Ammar Mansour Incised wounds Incised...

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Unformatted text preview: By: Ammar Mansour Incised wounds Incised Clean seperation or division of the full thickness of skin under the pressure of a sharp-edged instrument (knives or broken glass) Incised wounds Incised Types: Slash wounds: Length > depth. Generally NOT as serious as stab wounds unless it involves major blood vessel. Stab wounds: Depth > length. More SERIOUS as they tend to come in contact with vital organs in chest and abdomen. Comparison: Lacerations Lacerations Incised wounds Trace evidence (rust or dirt) Clean Shape is NOT according to Shape cause cause Shape is according to Shape cause cause Ragged edge Ragged Everted edge (turning outwards) (turning Everted RARELY self-inflicted RARELY May be self-inflicted Self-inflicted injuries Self-inflicted Self-inflicted injuries Self-inflicted Cuts are usually superficial, multiple and parallel. superficial multiple parallel In right handed people most of injuries are on the left side. left Certain sites : throats, wrists and the front of the chest are more common. They are often multiple, but there are deep cuts. hroat In slashing throat suicidal injury ,throwing back the head, moves the carotid bundle under the protection of the sternomastoid muscles. So if the cut is confines to the front of the neck, only the larynx or trachea may be damaged roat hroat Stab wounds of the neck are UNCOMMON in suicide. Wrist Deliberate cutting of the wrists is RARELY effective as a sole method of suicide but it is a COMMON injury )Chest Suicidal injury of the chest are almost always wounds stab Defense Wounds Defense Defense Wounds Defense Definition: A wound sustained when a victim places a hand, arm or other body part to prevent or minimize a blow or slashing by a sharp weapon. Usual sites: The outer-side of the forearm Back of the hand Fingers Bruises may be seen at the outer-side of the thigh as the victim crosses his legs to protect the genitalia. Duty of the Doctor Duty Make a detailed examination and provide a medical report that can be used in subsequent criminal or civil proceeding. The purpose of examination is to determine: The time of the wound in relation to death. How it was caused. What is the cause. What amount of force was used to produce it. The degree of injury that was caused by the wound (whether the wound influenced death or disability). :Changing in bruising Dark red. less than 24 hours •Dusky purple. •Brown. From 1-3 days Brown. •Green. 3 to 5 days Green. •Yellow.5 to 7 days Yellow.5 •Straw. How to describe a wound How The nature of the wound (bruise, laceration or abrasion). The wound dimensions (length, width and depth). The position of the wound in relation to fixed anatomical landmarks eg: distance from the mid line, distance below the clavicle…etc. The number of wounds. The margins of the wounds (Ragged or Everted) Factors affecting wound HEALING HEALING Blood supply. Infections. Age Site of wound. Nutritional status. Inter current diseases. Drugs: corticosteroids, immunosuppressive, radiotherapy, chemotherapy. Complications of wounds Complications Infection and sepsis. Bleeding Hypovolemic shock. Injury to internal organs. Formation of scar. Causes of DEATH due to wound wound Injury to a vital organ eg: brain. Injury eg: Sever hemorrhage. Sever hemorrhage Shock Pulmonary embolism. Pulmonary Septicemia Renal failure due to rhabdomyolysis (crush syndrome). syndrome). ‫ني‬ ‫بعز‬ ‫ك‬ Thank you ...
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