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Traumatology
Lacerations & Incised Wounds
3-Lacerations
These wounds are commonly known as 'gashes, tears or cuts' of the
skin. The skin surface is split or torn following blunt trauma, and the force
causes the full thickness of the skin to be damaged. Lacerations therefore bleed
profusely.
Areas of the body that are commonly the site of lacerations are those with
underlying bony support, such as above the eyebrows, on the scalp and face, or
over the knees etc, whilst they are less common on areas of the body that are
softer such as the buttocks.
![Lacerations](lacerations.jpg)
Contact with motor vehicles may also cause splitting of the skin due to grinding
type movements over the surface.
Lacerations have ragged wound edges, as they have been torn apart and not neatly
incised as in a surgical wound. However, scalp lacerations sometimes resemble
incised wounds when they have been caused by a regular shaped object. If the
wound is examined closely (eg with a hand-held magnifying glass), the ragged
edges can be visualised, along with,crushing and bruising
hairs driven into the tissues tissue strands (nerves, fibrous brands, vessels)
may cross the depths of the wound
4- Incised Wounds:
Incised wounds are sharp cut-like injuries, made by knives or broken glass
etc.The edges of the wound will vary according to the nature of the cutting edge
of the object, in that a razor will leave regular margins, whereas an axe may
leave the wound margins crushed and bruised, resembling a laceration.
Slash Wounds
These are wounds where the length is greater than the depth, eg a slice wound
across the skin. If the wound involves major blood vessels, it can be life
threatening, but in general, they are not as serious as stab wounds.
5- Stab Wounds
These are wounds where the depth of injury is greater than the length. They
penetrate more deeply than slash wounds and tend to come into contact with vital
organs in the chest and abdomen.Stabbing is the most common mode of homicide in
the UK, due to the strict control of guns.Stab wounds are caused most obviously
by knives, but are also caused by bayonets and swords, as well as scissors and
even blunter instruments such as screwdrivers.
These type of wounds have the following features,
They are usually slit-like, but when the object is removed the skin contracts
slightly, leaving a wound that is slightly shorter than the blade width. The
centre of the wound often widens.
Muscle and skin contracture around the wound often obscures the size of the
knife blade
The size of the wound depends upon the depth of penetration of the knife, and
whether, for example the parallel section of the knife has been reached (ie near
to the hilt of the knife)
If the blade is 'rocked' in the wound (ie either the assailant moves the knife
around, or the victim moves in relation to the knife), the wound is longer than
if the knife is inserted in and out rapidly and in the same direction
Irregular or 'V' shaped wounds arise when the knife is twisted in the wound
Most knives are single edged, and have a sharp cutting surface whilst the back
of the blade is blunt. The wound may be sharp at one end, and blunt at the
other. Unfortunately, this is not always the case, as the blunt edge of the
knife may split the skin, and resemble a double edged knife wound.
Knives that have a handle guard or 'hilt' may be present around the wound if
they are forcefully stabbed into the victim The depth of the wound is often
longer than the length of the knife because of the compressibility of skin and
underlying structures, particularly in the abdominal cavity
![Stab wound with a 'hilt'](incised.jpg)
It is important to realise that stab wounds can be made with minimal force. The
important factor is the sharpness of the tip of the blade - once it has
penetrated clothing and skin, remarkably little force is required to follow
through and create a deep knife wound. In addition, the faster the stabbing
action, the easier it is to penetrate skin.
6- Defence Wounds
A victim of assault can sustain quite characteristic injuries during the course
of the assault, as they try to defend themselves, and ward off blows. When
warding off knives, the victim usually has multiple incisions across the
palmar surfaces of the hands, where attempts have been made to grab the knife
blade.
![Posture for defence wounds](defence.jpg)
Links
Case
Studies of Murders
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