Injuries Associated With Assault & Abuse

    ( Re-posted from Xanga site)

        Identifying Injuries Associated With Assault And Abuse

     There are several types of trauma and injuries associated with assaults. In the medical field, among other things, we look for certain patterns of injury to indicate causation as well as possible identification of an assailant.

     Below are listed types most often associated with blunt force trauma from abuse or assault.

 Blunt ForceTrauma   

1. A moving object striking the body (Fist)
2. The body striking a fixed object (Fall)
3. Hitting, choking, gripping, pinching, squeezing, kicking, biting

     Symptoms: Bruises (contusions), abrasions, lacerations, bite marks.

                Types of Injuries      

  1)  Bruises:

• Caused by blood leaking out from small blood vessels into the surrounding tissues
• Caused by blunt force trauma
• Can be seen in skin, muscle or internal organs  
• Petechiae are tiny bruises < 2mm. They can be seen in the eyes, in the mouth or on the skin. Often seen with throttling or strangulation attempts or as the result of forced oral sex.
• Size, shape, severity is varied. Degree of force can't be determined accurately by the size of the bruise.
• Color changes are caused by the breakdown of the red blood cells and release of pigments.
• Cannot date bruises accurately
• Color starts out reddish and changes to purple to brown to yellow/green.
• The site of bruising doesn't always reflect the site of the trauma, due to expansion of blood through the tissues and the pull of gravity.
• Deeper bruising may take up to two days to appear on the skin surface. Red marks can show up almost immediately.
• Black skin may mask bruises. An ultraviolet light may need to be used.
• Bruises show more easily on bony prominences.
• Obese persons will bruise easier than non obese individuals.
• Females bruise easier than males.

     Finger Pad Bruises are cause by forceful gripping. They are slightly bigger than the actual fingers due to blood spreading. They're usually found on the face, throat, arms and thighs (rape).

   Counter Pressure Bruises are caused by the forceful restraint of a person against a wall or the ground. They're found on the bony prominences of the back.

   Black Eyes are caused by:

• Fist blow to the eyes
• Skull fracture
• Gravity pull on a bruised forehead.

   Punching is usually directed to the upper body, mostly the face. There may be abrasions, lacerations, lips gashed against the teeth - with teeth imprints; fractured nose and jaw. The assailant may have corresponding bruises of the knuckles.

   Kicking is usually done with shoes on.

• May be an imprint bruise from the tread of the shoe.
• A swinging kick may result in an curved imprint.
• Typical sites are the face, neck, groin, back and chest.
• Bruises of varying ages suggest repeated assaults, as usually seen in domestic violence cases.

2) Abrasions:
Very Important Forensically!

• Always occurs at the site of impact.
• Often indicates causative object (imprint abrasion)
• Often indicates direction of impact
• Caused by crushing, scraping or rubbing the skin.
• A superficial injury involving the epidermis and dermis.
• The top portion of the skin has been scraped away.
• Usually reddish color, with slight bleeding.
• Can be oozing.

   3) Lacerations:

• Caused by stretching or crushing of the skin from blunt force trauma.
• Term often used interchangeably with "cut" but it's not the same.
• Laceration is caused by blunt force. A cut is caused by sharp force.
• Healing time is affected by varying factors such as age, nutrition, medications, etc.

             Guidelines:

1. Fresh: ( (+) blood, edema) injury occured within the past 24 hours.
2. Healing: ( (+) granulation tissue, no blood) injury occured between 48 hours and 21 days. This stage can sometimes be seen by the nurse using the colposcope.
3. Healed ( (+) scar) injury can't be accurately dated.

• Goes through the full thickness of the skin
• Has a ragged edge
• Has associated bruising and abrasions
• Has tissue bridges in wound
• Trace evidence in wound
• Rarely self-inflicted

 

  

Comments

[Amal]

What a great blog. As a survivor of abuse, I salute you for posting what the injuries look like on the outside. If more can identify them, then maybe we can help stop the cycle.

[Kathleen]

Amal, thanks for your comment. I'm glad you find the blog informative. That's my primary goal for this site.