Stab and chop wounds mb singh 2020

forensic traumatology

1. Stab wounds Dr M Balaji Singh Professor of Forensic Medicine ACS Medical college and Hospital, Chennai. Courtesy DR . SONO MAL RATNANI , Farhan ali (slide share)

2. Sharp force injuries Incised wounds Chop wounds Stab wounds

3. Multiple stab injuries(5),over abdomen

4. Multiple stab wounds on the back

5. Multiple stab wounds

6. Massive stab wound , over left side of the back of the chest

7. Stab wound with tailing

8. Stab wound

9. stab wound definition : wound caused by a sharp pointed weapon driven in the body, the depth of the wound being the greatest dimension . Further describing as : 1. penetrating wound: when the weapon after passing through tissues opens in to some part or cavity of the body wound of entry present, but not wound of exit.

10. 2.perforating wound : when the weapon passes through & through the body or body part making two wounds i.e . wound of entrance, and wound of exit . .

11. causative weapons 1- pointed, sharp, flat objects __ knife, dagger, sword, sickle 2 - pointed, smooth and rounded objects ___ needles, 3 - blunt ended, rough surfaced __ iron crow bar ( iron rod ), pickaxe

12. Entry wound of stab Sharp pointed weapon causes- incised like stab wounds Blunt ended weapon causes- lacerated like stab wound

13. FEATURES of stab wound having all the features of incised wound, but depth is more than other dimensions . how to ascertain depth of wound : 1- in case of penetrating wounds: - in living - in dead body

14. depth of wound........ In living – on the operation table by the treating surgeon only in case of dead : during autopsy, depth is assessed by gauging or by gentle introduction of a blunt probe. 2. in cases of perforating wounds : the wound of exit is the guiding principle. .

15. characteristics of wound of entry & wound of exit wound of entry is generally bigger than the wound of exit. - pieces of cloth/fibres directed towards wound. - margins are clean cut & inverted . - abrasion/bruising of edges/margins due to effect of hilt of sword or dagger may be seen. shape of wound may corresponds the shape of weapon

16. WOUND OF EXIT - smaller with everted margins. cloth fibres are directed out wards.

17. WEAPON ----------- SHAPE OF entry WOUND 1.Single Sharp Edged- Weapon----- Wedge Shaped 2.Double Sharp Edged -Weapon- ---- Elliptical Shape 3.Rounded Pointed ------------------- Circular 4.Pointed -------------------------------- Square or Cruciate 5.Double Edged Blunt ------ Circular With Bruising 6.Instrument Twisted Before With Drawl.--------------------------- Triangular Or Cruciate (shape of a cross)  .

18. Medico legal importance- stab wounds Weapon used Manner of death Most of the time homicide, but suicide may possible Direction of infliction of force Relative position of victim and assailant Time of infliction of wound- by findings of healing or bleeding Cause of death- by damage to vital organs or hypovolemic shock

19. Cuts on the clothes in stab wounds Clothes damages mostly in case of homicide, or accidents. and cuts on clothes corresponds to site of stab wounds In case of suicide clothes are usually intact.

20. Suicidal stab by 18 years boy, knife is still in the second stab wound over chest

21. Surgical treatment Algorithm for stab injury Illustrated in flow chart in Next slide

22. Chop wounds

23. Chop wounds

24. Chop wounds are - deep gaping wounds by heavy sharp weapons

25. Gapping & Cleavge lines Skin tension lines(Langer’s lines)

26. Gapping…………… Gapping of the wound seen in sharp force injuries. Margins of the wound are separated, giving a spindle shape to a sharp linear cut. It is a vital reaction due to elasticity of the ‘ “ langres lines” in the skin . The wound will gape if cleavage lines (Langer’s lines) are cut transversely or obliquely. Gapping is minimal or nil if cut along with these lines. Gapping not seen in case of cuts on dead body.

27. Gapping…..

28. Chop wounds

29. Chop wounds

30. Chop wounds

31. The nature of the chop wound depends upon the sharpness of its blade, direction and angle of the blow , portion of the instrument caused the injuries differences in curvatures of the tissues, and skin folding. Underlying tissue(fat/ bone/muscle) of involved area

32. Chop wounds by axe ill-maintained weapons have some nicks and rusty deposits on edges and blades. - preventing the weapon to produce pure incision. When sharpened , - such weapons produce devastating incised wounds. - Even bone may be transected with clean cut margins with comparatively little effort.

33. Chop by axe……. A triangular trench like depressed fracture or cut will be seen over skull bone due to attack by the axe. which corresponds the cross-section of the axe blade- indicating the size and measurement of the blade of the weapon- hence called signature fracture.

34. chop wound- M L I

35. Chop wounds Direction • Usually the lower end (heel) of the axe strikes the surface first, which produces a deeper incised wound than the upper (toe) end. The deeper end indicates the position of the assailant

36. Chop wounds- direction of force • In the skull , the undermined edge of the fracture indicate the direction in which the force is exerted, or the slanted one is the side from which the force was directed • In case of long bones , the bone fragments get loosened on the opposite side of the force.

37. Defense wounds may be seen in case of assault

38. Defensive wounds may associate with homicidal stab or chop wounds

39. Thanking you