Laceration

Normally, pus formation occurs in about 48 hours, but in a lacerated wound it occurs slightly earlier.

Irregular margin

Blunt perpendicular impact

• Blunt force on areas where the skin is close to bone, and the subcutaneous tissues are scanty, may produce a wound which by linear splitting of the tissues, may look like incised wound.
• Lacerations produced without excessive skin crushing may have relatively regular sharp margins.

Features of lacerated wound:

• Margins are irregular, ragged and uneven and their ends are pointed or blunt
• Bruising is seen either in the skin or subcutaneous tissue around the wound
• Deeper tissues are unevenly divided with tags of tissue at the bottom of wound bridging across the margin
• Hair bulbs are crushed
• Hair and epidermal tags may be driven deeply into the wound
• Less hemorrhage
• Presence of foreign matter in the wound
• Shape and size of the wound does not correspond to the weapon used

C i.e. Laceration

B i.e. Laceration

Lacerated

A i.e. Scalp; B i.e. Tibial shin

A i.e. Scalp

Ans. Blunt object

Ans. Incised wound

Ans. Chest

Ans. Avulsion

Ans., Laceration

Ans. is ‘a’ i.e., Forehead

LACERATIONS (Tear or Rupture)

Lacerations are tears or splits of skin, mucous membrane and underlying tissue (e.g., muscle or internal organs). Lacerations are produced by application of blunt force to broad area of the body, which crush or stretch tissues beyond the limits of their elasticity. Localized portions of tissue are displaced by the impact of the blunt force, which sets up traction forces and causes tearing of tissues.

Features of lacerations are :‑

i) Hair and hair bulb, nerves and blood vessels are crushed → There may be paralysis (nerve crushed) and hemorrhage is not pronounced (blood vessels crushed).

ii) Site of injury is the site of impact.

iii) Shape of injury is irregular, margins are irregular and contused/abraded and show tags of tissue.

iv) Size of injury does not corresponds to impacting surface.

There are following types of laceration : ‑

1) Split laceration : Splitting occurs by crushing of skin between two hard objects. Blunt force on areas where the skin is close to rigid structures like bone with scanty subcutaneous tissue, may produce a wound that by linear splitting of tissue may look like incised wound, i.e., incised like or incised looking wound. Examples of such area are scalp, eye brows, cheek bones (zygomatic), lower jaw, iliac crest, perineum and skin. A wound produced by a fall on knee or elbow with limb flexed and by a sharp stone also simulates incised wound.

2) Strech lacerations : Overstretching of the skin, if it is fixed, will cause laceration, for example, by kicking, sudden deformity of bone occurs after fracture, making it compound.

3) Avulsion (shearing laceration) : An avulsion is a laceration produced by sufficient force (shearing force) delivered at an acute angle to detach (tear off) a portion of a traumatized surface or viscus from its attachment, the shearing and grinding force by a weight. Flaying is type of avulsion in which shearing and grinding force by weight (such as of lorry wheel passing over a limb) may produce avulsion (separation of skin from underlying tissue/degloving of a large area).

4) ears : Tears of the skin and tissues can occur from imact by a against irregular or semi-sharp objects, such as door handle of a car. This is another form of overstretching.

5) Cut laceration : Cut lacerations may be produced by a heavy sharp edged instrument.