This is a very concise and interesting lecture about the introduction of injuries and lacerations, it was presesnted inEast Afica University, Faculty Medicine, Department of Forensic Medicine.

1. East Africa UniversityEast Africa University
Faculty of MedicineFaculty of Medicine
semester:11semester:11

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IntroductionIntroduction
 Medical practitioners very frequently need toMedical practitioners very frequently need to
examine, treat victims and issue medico-legalexamine, treat victims and issue medico-legal
reports in pursuit of their profession dealing withreports in pursuit of their profession dealing with
wounded persons.wounded persons.
 Law enforcing officers may send the woundedLaw enforcing officers may send the wounded
victims for routine treatment and necessarily forvictims for routine treatment and necessarily for
medico-legal reports of the cases.medico-legal reports of the cases.

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 Occasionally the victims from their own selves request theOccasionally the victims from their own selves request the
attending medical practitioners to issue medical certificatesattending medical practitioners to issue medical certificates
and reports which will be needed to start a legal actionand reports which will be needed to start a legal action
against the accused persons.against the accused persons.
 This is why the medical practitioners have to use theirThis is why the medical practitioners have to use their
medical knowledge and skill regarding hurts or injuries,medical knowledge and skill regarding hurts or injuries,
different causative weapons or means for making verydifferent causative weapons or means for making very
useful medico-legal reports and on a later date to act asuseful medico-legal reports and on a later date to act as
competent expert witness in the courts of law.competent expert witness in the courts of law.

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DiscussionDiscussion
 The terms hurt, injury and wound have almost theThe terms hurt, injury and wound have almost the
same meaning and some differences as well. Theysame meaning and some differences as well. They
usually meanusually mean any damage toany damage to any part of the bodyany part of the body
or bodily harm caused by application ofor bodily harm caused by application of
violence.violence.
 Injury also includes any harm to the mind,Injury also includes any harm to the mind,
reputation and property, and hurt includes bodilyreputation and property, and hurt includes bodily
pain, disease or infirmity.pain, disease or infirmity.

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DEFINITION OF WOUNDS
Medical definition:Medical definition:
Disruption of theDisruption of the
continuity of the tissuescontinuity of the tissues
produced by externalproduced by external
mechanical force.mechanical force. Legal definition:Legal definition:
Breach of the fullBreach of the full
thickness of the skinthickness of the skin

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 Clinically a wound is produced when there is breachClinically a wound is produced when there is breach
of anatomical continuity of the skin or mucousof anatomical continuity of the skin or mucous
membrane with or without damage of the underlyingmembrane with or without damage of the underlying
tissues.tissues.
 Forensically it is wound when there is damage ofForensically it is wound when there is damage of
any tissue or organ irrespective of breach ofany tissue or organ irrespective of breach of
continuity of the skin or mucous membrane.continuity of the skin or mucous membrane.

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Production of woundProduction of wound
 A wound is produced when the intensity of theA wound is produced when the intensity of the
applied force to the body exceeds the capability ofapplied force to the body exceeds the capability of
the tissue to adapt or resist the force.the tissue to adapt or resist the force.
 The capability of the tissue to adapt or resist theThe capability of the tissue to adapt or resist the
force depends on mass, velocity, exact area of theforce depends on mass, velocity, exact area of the
weapon pressing the body, structure of the tissue,weapon pressing the body, structure of the tissue,
mode of application of the applied force likemode of application of the applied force like
compression, traction, torsion, tangent and leveragecompression, traction, torsion, tangent and leverage
of the stress.of the stress.

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 Type of damage of the tissue depends on theType of damage of the tissue depends on the
degree of transfer of the kinetic energy from thedegree of transfer of the kinetic energy from the
relative movement of the weapon and/or the body.relative movement of the weapon and/or the body.

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Types of mechanical traumasTypes of mechanical traumas
1.1. Non-penetrating (Blunt trauma)Non-penetrating (Blunt trauma)
It is caused by force applied with a blunt object.It is caused by force applied with a blunt object.
When the limits of load tolerance exceeded,When the limits of load tolerance exceeded,
tissues are disrupted.tissues are disrupted.
22. Penetrating trauma. Penetrating trauma
it is caused by when a foreign body enters the bodyit is caused by when a foreign body enters the body
tissue, creating an open wound; e.g. a knife (sharptissue, creating an open wound; e.g. a knife (sharp
trauma) or a bullet (firearm injury).trauma) or a bullet (firearm injury).

10. Medico legal divisions of wounds (based
on nature(
1-Accidental
2-Suicidal
3-Homicidal
4-Self inflecting

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Medico-legal classification (based on theMedico-legal classification (based on the
etiology)etiology)
1.1. AbrasionAbrasion
2.2. Contusions or bruisesContusions or bruises
3.3. Lacerated or contused woundsLacerated or contused wounds
4.4. Incised or cut woundsIncised or cut wounds
5.5. Stab woundsStab wounds
6.6. FracturesFractures
7.7. Firearm woundsFirearm wounds

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Types of woundsTypes of wounds
Abrasions
Bruises
Lacerations
Incised
Wounds

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Types of woundsTypes of wounds

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Legal classification (according toLegal classification (according to
the severity)the severity)
1. Simple wounds1. Simple wounds
Which heal in less than 20 days leaving no permanentWhich heal in less than 20 days leaving no permanent
infirmity.infirmity.
2. Dangerous wounds2. Dangerous wounds
Which heal in more than 20 days or leave a permanentWhich heal in more than 20 days or leave a permanent
infirmity.infirmity.
3. Fatal mortal wounds3. Fatal mortal wounds
Which lead to death, immediately or within a short time afterWhich lead to death, immediately or within a short time after
its infliction.its infliction.

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““Permanent infirmity” can be defining as loss ofPermanent infirmity” can be defining as loss of
functioning organ, or loss of the function of this organfunctioning organ, or loss of the function of this organ
as permanent loss of vision after trauma.as permanent loss of vision after trauma.
While loss of a non-functioning organ is referred to asWhile loss of a non-functioning organ is referred to as
“ Disfigurement” as loss of a blind eye.“ Disfigurement” as loss of a blind eye.

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Laceration / Contused woundsLaceration / Contused wounds
 Tearing, splitting or rupture of the skin andTearing, splitting or rupture of the skin and
subcutaneous tissues due to compression osubcutaneous tissues due to compression o
grinding by heavy blunt object; e.g. motorgrinding by heavy blunt object; e.g. motor
vehicles accidents or falling from height.vehicles accidents or falling from height.
 Usually due to blunt force trauma that exceedsUsually due to blunt force trauma that exceeds
thethe elastic capacity of the skin and underlyingelastic capacity of the skin and underlying
tissues.tissues.
 Typically over boney prominence (scalp,Typically over boney prominence (scalp,
eyebrows, cheek, chin).eyebrows, cheek, chin).

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LacerationLaceration
CharacteristicsCharacteristics
 Slightly inverted margins.Slightly inverted margins.
 Margins are often bruise and abraded.Margins are often bruise and abraded.
 Ragged woundsRagged wounds
caused by crushing and tearing of the skincaused by crushing and tearing of the skin
 Gape openGape open
 Minimal bleedingMinimal bleeding
 Hair is crushedHair is crushed
 Healing is usually delayedHealing is usually delayed

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ShapesShapes
 May give some indication as to the agent responsible.May give some indication as to the agent responsible.
 Blows to the scalp with the circular head of a hummerBlows to the scalp with the circular head of a hummer
or a spherical knob of a poker tend to cause crescenticor a spherical knob of a poker tend to cause crescentic
laceration.laceration.
 Weapon with square or rectangular face such as theWeapon with square or rectangular face such as the
butt of an axe may cause laceration with a Y-shapedbutt of an axe may cause laceration with a Y-shaped
split at its corners.split at its corners.
 Perineum: rapePerineum: rape

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Sub-types of lacerated woundsSub-types of lacerated wounds
1.1. Crushed woundsCrushed wounds
2.2. AvulsionAvulsion
3.3. Split (cut-lacerated) woundsSplit (cut-lacerated) wounds
4.4. Torn woundsTorn wounds

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Medico-legal importanceMedico-legal importance
 Shape and size not usually related to causal.Shape and size not usually related to causal.
 Rarely self-inflected.Rarely self-inflected.
 Trace evidenced in wound (rust or dirt).Trace evidenced in wound (rust or dirt).

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““When you were born, youWhen you were born, you
were crying andwere crying and
everyone around youeveryone around you
was smiling. Live yourwas smiling. Live your
life so that when youlife so that when you
die, you're the one whodie, you're the one who
is smiling and everyoneis smiling and everyone
around you is crying.”around you is crying.”

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