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        Penetrative injuries are injuries that pass through the skin to enter the body cavities/deep tissues.

Therefore death can be caused by either damage to internal organs or hemorrhage by damage to major vessels

 
                                                        

 

                                               Types of penetrative injuries

  •     Stabs            - caused by flat , thin bladed sharp cutting weapons

                                                e.g. dagger, pen knives, table knives

  •     Punctures      - caused by weapons where only the tip is pointed and rest of the weapon blunted

                                               e.g. needles (knitting, sewing), pointed cycle spokes

  •    Perforations   - caused by long blunt ended weapons

                                               e.g. screw drivers, probes

 

 

                                        Medico legal importance  

  •  The features of a stab wound would indicate the qualities of the knife 

            - Whether single/double cutting edge and presence/absence of a hilt guard 

                                              

Injury with one end cut & the other end torn making a 'Fish Tail' [arrow]

                           

                                             

The knife used would have been one with a single cutting edge

      ? Exception

 

 

                   knife with single cutting edge

                   

 
         Injury with both ends cut

                 

                        

The knife used would have been one with a double cutting edge

 

 

 

                       Knife with double cutting edge - e.g. sword
Injury with an  imprint abrasion

    

 

The knife used would have been one with a hilt guard

                    

 

                    Knife with a hilt guard - e.g. Dagger

 

 
                     - The sharpness, thickness, width of the blade cannot be commented on accurately as dimension of the wound depend on factors other than the features of the blade of the weapon         
              -Depth of the wound corresponds to the length of the blade  except in some circumstances

 
             -The shape of the blade can be determined by deep dissection of tract along the soft tissues and examination of cuts in bone

                                                                                  

 
                                                    
 

   It is important to dissect the body with the weapon in situ in order to see the pathway of the wound

  •  Wounds of different sizes may be caused by a single weapon   ?Reasons

 
                                                                                          

                                                                                                               

        

  • Determination of the force required to cause a penetrative injury.

          This depends on the type of weapon used and the area of body stabbed

  

  • Time of injury may be estimated by the degree of healing

 
  • Should look for underlying injuries
  A..                            B.   

 

 

A. Specimen shows stab injury through skin with underlying heart injury (white arrow)

B. The consequence of the stab was haemopericardium (white arrow) resulting cardiac tamponade and death 

 
  • Documentation of a stab injury is important

 
                     Stabs to back of the neck   

                                       

   

 

 
  • Should differentiate antemortem from postmortem penetrative injuries

 
  • Puncture wounds will show rounded circular shape with marginal bruises & abrasions
   

                puncture of the hand by a needle

 

 

 

 

 

                                 

 
  • Perforated wounds have marginal bruises and abrasions and torn margins

Perforation  of the upper arm caused by a screw driver                                                                                                                         

                                                                                                                       

 
  • Indicates the circumstances of injury

                                                -  Homicidal - most commonest - mostly over chest, neck, abdomen

             

 

             Stab to neck

                  

                                   

                      Stab to abdomen     

          

 

 

 
                                                                     -  Suicidal  - chose accessible areas and not the back
                                                                     -   Accidental  -  rare - fall on to a knife