WOUNDS: DOCUMENTATION AND INTERPRETATION

• Jurisdiction: Australia

Introduction ................................................................................................... [41.1700]

Wound description ........................................................................................ [41.1720]

Wound classification ..................................................................................... [41.1740]

Injury patterns ............................................................................................... [41.1760]

Assaults ......................................................................................................... [41.1780]

Defensive injuries .......................................................................................... [41.1800]

Self-inflicted injuries ...................................................................................... [41.1820]

Injuries resulting from interaction with law enforcement agencies ............... [41.1840]

Serious injuries .............................................................................................. [41.1860]

[41.1700] Introduction

Forensic practitioners are frequently required to address questions arising from an injury. These questions may be posed by the medical practitioner, by investigators, by legal practitioners or by the courts. Issues arising include:

• the age of an injury;
• the mechanism by which the injury was produced;
• the amount of force required to produce such an injury;
• the circumstances (or manner) by which the injury was sustained;
• the consequences of the injury; and
• alternative explanations as to how an injury may have occurred.
• investigators frequently ask practitioners to determine the seriousness of the injuries

Injury interpretation is both complex and fundamental to the practice of forensic medicine. It requires an integration of anatomical, physiological and pathological principles.

A wound may be defined as a disruption of continuity of tissue by physical injury. (In some jurisdictions there may be precise statutory definitions.) The term "injury" is often used synonymously with "wound" but frequently has a wider meaning, including not only damage produced by physical forces but also damage produced by thermal, chemical, electrical and radiation effects.

[41.1720] Wound description

The aim of the description is to provide a word picture for a (generally lay) audience. The use of a standard set of parameters to describe all injuries assists by ensuring that none of the critical descriptive elements are omitted. It also provides a starting point for exploring the issues of how, when, where and what - the process of event reconstruction. The following features of a wound could be recorded:

• site - the wound's anatomical position;
• size - measured or estimated;
• shape - eg linear, curved, irregular;
• surrounds - description of the adjacent tissues;
• colour - may be relevant when describing bruises;
• course - the apparent direction of the injurious force (eg, as in abrasions);
• contents - the presence of any foreign material in the wound (eg, dirt or glass);
• age - any evidence of healing;
• borders - a description of the wound edges and surrounding tissues may give some clues as to the causative implement;
• classification - use accepted word terminology (see [41.1740]);
• tenderness - the presence or absence of apparent discomfort when palpated; and
• depth - in clinical medicine this is generally an estimate.

These descriptors will allow the assessing practitioner, and others who may be required to review the matter, to draw an accurate conclusion about the features of the wound. The use of simple descriptive language is critical to the accurate interpretation of a wound.

[41.1740] Wound classification

The use of a standardised terminology for classifying wounds is of considerable value to the understanding of the circumstances (eg, accidental, assaultive, self-inflicted or a combination of these) by which the injuries may have been sustained. See the Forensic Pathology chapter for an extensive description of the diagnostic features of wounds.

[41.1760] Injury patterns

Assessment of the injury pattern refers to a process whereby injuries sustained by the individual are reviewed with particular reference to the number, types and location of those injuries. It is through such an analysis that it may be possible to make some objective conclusion as to the circumstances or manner in which the injuries were (or were not) sustained: accidental, assaultive, self-inflicted or some combination of these. The following section explores five examples where the interpretation of an injury pattern may hold particular importance:

• injuries that may occur during an assault;
• injuries arising from an individual's attempt to defend herself or himself from the assaultive actions of another;
• self-inflicted injuries;
• injuries that may be sustained during contact with law enforcement agencies; and
• serious Injuries.

[41.1780] Assaults

Assaults are dynamic, violent interactions...