INCISED WOUND

1. INCISED WOUND

2. INCISED WOUND • An incised wound is a clean cut through the tissues, caused by sharp edged weapons. • The wound is longer than it is deep. • The force is delivered over a very narrowarea, corresponding with the cutting edge of the blade.

3. INCISED WOUND

4. INCISED WOUND

5. Causes • Striking the body with the edge of sharp cutting weapon. • By drawing the weapon, against the body surface. • By using the weapon like a saw in which case there may be more than one cut in the skin at the beginning of the wound which merge into one at the end.

6. Characters 1. Margins • The edges are clean cut, well defined and usually everted. • The edges may be inverted, if a thin layer of muscle fibres is adherent to the skin as in the scrotum. • Contusion and abrasion are absent.

8. 2. Width • Width is greater than the thickness of the edge of the blade, due to retraction of the divided tissues. 3.Length • The length is greater than its width and depth, and has no relation to the cutting edge of the weapon . • There may be superficial tail at the termination known as tailingof the wound which indicates the direction.

9. 4. Shape • It is spindle shaped due to greater retraction of the edges in the centre. • Gaping is greater if the underlying muscle fibres have been cut transversely or obliquely and less if cut longitudinally. • The wound may take zig- zag course if the skin is loosely attached as in axillary folds because the skin is pushed in front of the blade before it is cut. • If blade is curved, the edge will be crescentic. • If surface is convex such as occiput or buttocks, then also shape will be crescentic.

10. GAPING

11. 5.Haemorrhage • More bleeding due to cutting of vessels. 6.Direction • Incised wound are deeper at the beginning, known as head of the wound . • Towards the end of the cut the wound becomes increasingly shallow, known as the tailing of the wound. It indicates the direction.

12. TAILING

13. 7. Bevelling cut • If the blade of weapon enters obliquely , the wound will have a bevelled margin on one side with undermining on the other side, indicating the direction from which the blade entered. • Bevelling can be produced by sharp weapon only. • It is usually homicidal and indicates the relative position of assailant and victim.

14. Age of the Incised Wound • Fresh: Haematoma formation. • 12 hours: Edges are red swollen and adherent with blood and lymph; leucocytic infiltration. • 24 hours: A continuous layer of endothelial covers the surface, overlying this a crust or scab of dried clot is seen.

15. Histopathology • Few minutes: Dilatation of capillaries and margination and emigration of the neutrophils. • 12 hours: Reactive changes in fibroblasts, monocyte appear in exudate, leucocyte infiltration. • 15 hours: Monocyte undergo mitotic division • 24 hours: Epithelium begins to grow at the edges.

16. 72 hours: Neutrophils are replaced by macrophages. Granulation tissue formed. • 4-5 days: New fibrils are formed. • One week: Soft, reddish scar in small wounds. In healing by secondary intension, inflammatory reaction is more intense and much large amount of granulation tissue is formed.

17. WOUNDS BY GLASS • Wound produced by glass are lacerated but resemble incised and stab wound.

18. Medico-legal importance • They indicates the nature of the weapon. • Age of the injury can be determined. • They give idea about the direction of the force. • Position and character of wound may indicate mode of production i.e. suicide, accident, homicide.

19. Circumstances 1.Suicide • They are multiple and parallel. • They are uniform in depth and direction. • They are relatively minor. • The fatal wound are present on accessible areas . • Hesitation cuts or tentative cuts or trial wounds: they are multiple small, and superficial involving only the skin and are seen at the beginning of the incised wound.

20. SUICIDAL INCISED

21. 2. Homicidal • They are usually multiple and can occur in any region of the body. Wounds on the chest are present over the wide area and are more horizontal. • The direction is from below upwards. • Wounds on the inaccessible parts are usually homicidal. • Wounds on nose and genitals are usually homicidal.

22. 3. Accidental • Common in the home or at the workshop and of minor nature. • They may be produced by knife, razor, etc. • In decomposed body it is difficult to differentiate between laceration and incised wounds.

23. Differences between Homicidal and Suicidal Cut throat wounds Suicidal wounds Homicidal wounds 1. Usually on both sides. 2. Low, on or below the thyroid cartilage. 3. Transverse or from below upwards. 4. Multiple, cross each other at deep level. 5. Sharp and clean cut. 6. Absent 1.Situation: Left side of neck 2.Level: High, above the thyroid cartilage 3.Direction: Above downwards and from lt. to right in rt. handed person. 4.Numbers of wounds: Multiple, superficial, parallel and merge with main wound. 5. Edges: Usually ragged due to overlapping of multiple superficial incisions. 6. Hesitation cuts

24. 7. Absent 8. More severe 9. No wounds on wrist, but several injuries on head and neck. 10. Defence wounds present 11. Fragments of clothing, hair, etc. in hands. 12. Usually absent. 13. Jugular vein and carotid artery are likely to be cut. 7. Tailing 8. Usually less severe 9. Other wounds: Often present across the wrist, thigh, knee but rarely on neck. 10. No defence wounds 11. Weapons in hands d/t cadaveric spasm 12. Weapon: Present 13. Vessels: Carotid artery escapes injury .

25. 14. Blood stains: On the mirror, front of body and clothes, above down wards & splashes over feet. 15. Clothes: Not cut or damaged. 16. Circumstantial evidence : Quiet place, locked room, usually stands in front of mirror, suicidal note may be found. 14. If asleep runs down on both sides of neck. 15. May be cut, disarranged, torn or loss of buttons. 16. Disturbance at the scene.

26. CHOP WOUNDS (SLASH WOUNDS) • They are deep gaping wounds. • Caused by a blow with the sharp cutting edge of a fairly heavy weapon, like a hatchet, an axe, sword, chopper. • Margins are sharp and may show slight abrasion and bruising with marked destruction of underlying tissues. • If edge is blunt, the margins are ragged and bruised. • The undermining occurs in the direction towards which the chop is made.

27. In the skull, the underminededge of the fracture defect is direction in which the force is exerted, and the slanted edge is the side from which the force was directed. • The wounds on the head and trunk are usually associated with injuries to important structures and are fatal.

28. Most of these injuries are homicidal • Accidental injuries can be caused by power fans, airplane propellers. • Suicidal chop wound are rare.

29. Questions on incised wound Question 1. Depth of incised wound is greatest at the point of: • Entry of weapon. • Exit of weapon • Away from weapon • Any of the above

30. Question 2. One of the following feature of incised wound indicates direction of wound : • Edge • Tailing. • Gapping • Bevelling

31. Question 3. Hesitation cuts are characterised by : • Direction of wound • Caused by small weapon • Present over accessible part • All of the above.

32. Question 4. Incised wound over genitalia are mostly : • Suicidal • Homicidal. • Accidental • PM artefact

33. Question 5. Incised looking wound are found over all except : • Abdomen • Head. • Shin • Face

34. Question 6. Tentative cuts are features of : • Homicidal • Suicidal. • Accidental • Grievous injury

35. Question 7. A curved weapon like sickle can produced : a. Stab wound b. Incised wound c. Both a & b d. Lacerated wound

36. Question 8. A clean incised wound heals by : • Primary intention. • Secondary intention • Excessive scarring • No scarring

37. Question 9. Incised looking wound is in fact : • An incised wound • An lacerated wound. • A firearm injury • Not a wound

38. Question 10. Maximum bleeding is seen in : • Lacerated wound • Incised wound. • Abrasion • Bruise