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Different Types of Wounds

  1. Abrasion :
    1. Destruction of superficial layer of epidermis of skin. It is 2-D (length and breadth)
Patterned abrasion.
  1. Actually three choices are correct- 
    • Patterned bruise     
    • Patterned abrasion
    • Imprint abrasion. But patterned abrasion is a better answer.
  2. Abrasion is of four types:
    • Scratches (Linear abrasion) - An abrasion by sharp or pointed object, not sharp enough to incise, but pointed enough to scratch eg. Fingernais, pin, thorn, tip of knife. Scratches have length but no significant width. Fingernail abrasions are straight or curved, one to two mm breadth, half to one cm long, wide at start, narrow at the end.
    • Grazes (Sliding, scraping or grinding abrasion) - Caused by movement between skin and some rough surface in contact with it. They are commonly seen in road traffic accident. A Graze abrasion caused by violent tangential rubbing against a surface as in dragging over the ground is called brush burn or gravel rash. They are the most common type.
  3. Pressure abrasion (crushing or friction abrasions) – caused by crushing of superficial layers of epidermis and are associated with bruise of surrounding area. Movement is around 90 degree to skin. In this abrasion movement is slight and directed inwards. Examples are ligature mark of hanging and strangulation.
  4. Impact abrasion (contact or imprint abrasion) - Caused by impact with a rough object, when the force is applied at or near right angle to skin surface. Example when a person knocked down by a motor car, the pattern of the radiator grill, a headlamp rim or tread of tyre may be seen on the skin.
  5. Impact and pressure abrasions are patterned abrasions. They reproduce the pattern of the object producing it. Patterned abrasions are produced when force is applied at right angle to surface of the skin. 
  6. If the skin is run over by a tyre, the ridges of the tyre damage the epidermis producing patterned abrasion, and the skin may be compressed into the alternating grooves of the tyre causing deep intradermal patterned bruise. So In case of tyre marks the ridges produce the patterned abrasion and grooves produce patterned bruise.

Note: Antemortem abrasions can be confused with Ant bite marks, Excoriations by excreta and pressure sores

  1. Age of abrasion:
i. Fresh - bright red
ii. 12-24 hrs - bright scab (drying of lymph and blood)
iii. 2-3 days - reddish brown scab
iv. 4-7 days - epithelium growth covering the defect under the scab
v. > 7 days - scab dries and falls off    

  1. Contusions (Bruises)
    Effusion of blood into the tissues due to rupture of subcutaneous vessels caused due to violence. Loose tissues like face, vulva, scrotum show large bruise with slight trauma. Strongly supported tissues like abdomen, back, scalp, palm and soles show small bruise with moderate trauma. Children and old people bruise more easily.
a. 1 - 2 hrs - Red
b. Few hrs - 3 days - Blue
c. 4th day - Brown (haemosiderin)
d. 5 – 6 days - Greenish (haematoidin)
e. 7 – 12 days - Yellow (bilirubin)
f. 2 weeks - Original colour
  1. Difference between Hypostasis & Bruise





Distension of capillaries & veins

Rupture of blood vessels


Over most dependent parts of body

Occur at site of injury, anywhere on body


No elevation of involved area

Swollen, due to collected blood & oedema


Not abraded

May be abraded


Clearly defined

Merge with surrounding tissues



Varying colour according to age


Blood easily washed away by a gentle stream of water

Blood firmly clotted, not easily washed away by a gentle stream of water

Effect of pressure

Absent in areas of less pressure

Little lighter over areas of pressure

  1. Difference types of bruise

    1. Ectopic bruise: site of injury and site of bruise are different. bruising is delayed bruise do not indicate direction of force.
      1. BATTLE’S SIGN: fracture of middle cranial fossa à bruise of mastoid process
      2. RACOON’S SIGN (Black Eye): fracture of ant. cranial fossa à bruise of B/L periocular region
    2. Artificial bruises: Semicarpus anacardium, calotropis
      1. Incision test: differentiates bruise from hypostasis.
      2. In bruise, on incision, blood is seen in surrounding tissues and cant be washed away.
      3. In hypostasis, on incision blood is seen in blood vessels and is easily washed away.
  2. Incised wound: clean cut, longer than deeper. Deeper at the beginning, shallow at the end, known as TAILING OF THE WOUND * (indicates direction).
  3. Hesitation marks/ tentative cuts/ trial wounds: multiple, small and superficial often involving the skin, seen in suicide.
  4. Stab / puncture wounds : deeper then its width or length.
  5. Harakiri: unusual type of SUICIDE practised in japan. inflicts stab wound on the abdomen pulls out the intestine. death due to sudden cardiac collapse due to fall on intra abdominal pressure.
  6. Laceration : Tear of skin , mucous membrane , muscle , internal organ produced by application of blunt force to broad area of body.


  1. Split laceration: Splitting occurs by crushing of the skin between two hard objects. Scalp lacerations occur due to the tissues being crushed between skull and some hard object, such as the ground or a blunt instrument.
  2. Incised–like or Incised–looking wounds: Lacerations produced without excessive skin crushing may have relatively sharp margins. ExamplesQ- on sites like shin, scalp, eyebrows, cheek-bones, lower jaw, iliac crest, knee and perineum. A wound produced by a fall on the knee or elbow with the limb flexed and by a broken or sharp stone also simulates incised wound.
  3. Stretch lacerations: Overstretching of the skin, if it is fixed, will cause laceration e.g. Kicking, sudden deformity of bone occurs after fracture, making it compound.
  4. Avulsion: 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.
  5. Tears: Tears of the skin and tissues can occur from impact by or against irregular or semi-sharp objects, such as door handle of a car. This is another form of overstretching.
  6. Cut lacerations: Cut lacerations may be produced by a heavy sharp edged instrument.)
  1. Defence wound
    As immediate reaction of the victim to save himself, by raising the hand or grasping the weapon.
  1. Incised–looking lacerated wounds: 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 tissue, may look like incised wound.. ExamplesQ- on sites like shin, scalp, eyebrows, cheek-bones, lower jaw, iliac crest, knee and perineum.)
  2. Lacerated looking incised wounds: It occurs where the skin is loose i.e. scrotum and axilla. 
  1. Pedestrian injury
    The distribution and severity of pedestrian injury depend on the speed and momentum of the impacting vehicle.

    Type of injuries
    1. Primary impact injury- these are produced by the initial contact with the vehicle, and may be in the form of abrasion , laceration, or contusions.
      Most commonly both legs get fractured in the region of impact with bumper of the vehicle ( BUMPER FRACTURE )
    2. Secondary impact injuries – caused by subsequent contact of body with vehicle after the primary impact. They usually result from the victim flung into the air after the primary impact and subsequent landing against the hood, windscreen or roof of vehicle. Head injuries are common.
    3. Secondary injuries (Tertiary Impact injuries) caused by striking against objects or surfaces other than the vehicle such as road surface or street poles. Grazed abrasion, flaying injuries etc. due to being dragged on the road are common.

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