Lacerations: complications, circumstances and associated blunt injuries
THE CONTEXT
Lacerations can cause serious complications, while their pattern and associated injuries may help explain how they were produced.
Complications
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Laceration of an internal organ can cause severe or fatal bleeding. Temporal arteries may bleed freely because they are firmly bound and unable to contract.
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Multiple lacerations confined to skin and subcutaneous tissue can collectively cause enough haemorrhage to produce shock and death.
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Infection is a complication. At sites where skin stretches or wrinkles, such as joints, continued oozing of tissue fluid and blood may cause irritation, pain and dysfunction.
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Crushing of subcutaneous tissue may cause pulmonary or systemic fat embolism.
Interpretation of injury patterns
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The type of laceration may indicate the cause of injury and the shape of the blunt weapon. Foreign bodies may indicate the circumstances of the crime, and the injury's age may be assessed.
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Violent, uncoordinated muscular contractions can cause fractures and lacerations of tendons and muscles. Internal forces and hydrostatic pressure during convulsions can cause mural lacerations of hollow viscera.
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Suicidal lacerations are usually on exposed body parts and mostly on the same side. Homicidal wounds are usually seen on the head.
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After a fall on the head, a circular abraded scalp surface completely surrounds the laceration. A blunt, narrow object, such as an angle-iron edge or crowbar, produces a linear tear with finely abraded margins.
Combined injuries and punching
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Abrasions, contusions and lacerations frequently coexist. Different blows from the same object may cause different injury types, and a single blow may produce all three.
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An object's imprint may be difficult to classify as primarily an abrasion or a contusion.
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Punching produces abrasions and contusions, with lacerations possible over bony prominences. Facial punches may split the lips, fracture teeth, nose, jaw or maxilla, and produce a black eye.