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Key Points

From a forensic perspective, it is necessary to usage the correct terminology once describing wounds.Lacerations are resulted in by blunt-force trauma.The hallmark of lacerations is the existence of organization bridging.Incised wounds are brought about by sharp-force trauma, usually by a sharp-edged object.The wound edge can aid distinguish a laceration native an incised wound/cut.

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The Case: A 24-year-old male presents to the emergency room sustaining the wound displayed in number 1 indigenous a damaged beer bottle. He claims that someone broke the bottle and cut him v it. What is the correct discharge diagnosis because that the chart?

Answer: Incised wound or cut.

Discussion

Although emergency medication providers commonly describe any break in the skin together a laceration, this hatchet is forensically and technically incorrect. A laceration is defined as a tear in tissue brought about by a shearing or crushing force.1,2 Therefore, a laceration is the result of a blunt-trauma mechanism. A laceration is further characterized by incomplete separation of stronger tissue elements, such together blood vessels and also nerves. These stronger tissue elements account for “tissue bridging” i beg your pardon is checked out in lacerations (see figure 2). In addition, lacerations commonly occur end bony prominences and tend to it is in irregularly shaped with abraded or contused margins. Lacerations are typically caused by difficult objects prefer a pipe, rock, or the ground. The crushing mechanism may have actually an result on wound healing and scarring and increased risk of epidemic from the devitalized tissue.

A cut or incised wound is developed by a spicy edge and is usually much longer than the is deep (see figure 3).1,2 because of the sharp-force system of injury, incised wounds lack tissue bridging and often display really clean, spicy wound edges. Knives, crate cutters, glass, and also metal typically cause incised wounds. In contrast, stab wounds room sharp-force injuries developed by a spicy instrument where the depth that the wound is higher than the size of the wound on the skin. When again, there is no tissue bridging.


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Figure 1. Wound from a damaged beer bottle. Figure 2. Laceration (caused by blunt pressure trauma), mimicking a sharp force injury. The existence of “tissue bridging” (arrows) help to identify a laceration from a sharp injury. Figure 3. an incised wound the the face. Note that the wound is longer on the skin surface than it is deep.

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An easy method to psychic the difference is to think the a glass beer bottle. If who takes the bottle and also smashes it over someone’s head and also the skin is opened, that is a laceration. If a person breaks the bottle on a table and uses the piece to slash someone, the is an incised wound.

References


Topics: an important CareEmergency PhysicianEmergeny DepartmentForensicsPractice ManagementProcedures and SkillsTrauma and Injury