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The dorsal surface of the left hand showing an oblique 2 cm superficial incised wound of the skin, just proximal to the metacarpophalangeal joint of the index finger. A near vertical full thickness incised wound of the skin (1.5 cm) lies between the middle and ring finger metatarsal bones, proximal to the metacarpophalangeal joints, with surrounding purple bruising
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“Defense” type wounds are sustained when a victim is attempting to ward off an attacker, or a weapon. A 39-year-old woman is reported who was found deceased with incised wounds to the dorsa of both hands that resembled defense wounds. Examination of the flexor surfaces of both wrists, however, revealed horizontal incised wounds typical of self-infl...
Citations
... Generally, along with the lethal wound, other superficial, sharp, forced skin cuts are described in cases of suicides, which are reported as the tentative wounds before the lethal one. In case of suicide there are no defense wounds, although uncommon self-inflicted sharp force injuries on the flexor surfaces of both wrists can mimic them [8,9]. Hence, wrists or throat self-cuts are frequently reported in the forensic literature as one of the detrimental methods in the event of complex suicide [10]. ...
A case of suicide committed by self-cutting the arteriovenous fistula in a patient on hemodialysis is presented. A 77-year-old man was found dead with a blood-stained kitchen knife in the bedroom by his daughter. The man suffered from severe chronic renal failure, for which he needed hemodialysis. Moreover, he was recently diagnosed with bladder cancer relapse. At autopsy, there was a single incised wound on the anterior surface of the left forearm, which showed a regular slash of the skin and the subcutaneous tissues. After the dissection, there was a small-sized lesion affecting the arteriovenous fistula wall. Furthermore, faint postmortem lividity and diffuse visceral pallor were observed. Consequently, the cause of death was identified as an acute hemorrhagic shock after self-cut of the arteriovenous hemodialytic fistula. This case is worthy of several medicolegal considerations: firstly, autopsy examination should always be required in cases with atypical injuries, providing important data to differentiate suicides from homicides. Secondly, disease-knowledge-related suicides are an emerging phenomenon, which deserve careful analysis. Lastly, it is important to identify patients with chronic diseases for whom psychological support is needed, preventing suicidal ideation and reducing suicide risk.
... Es existieren einige Fallberichte zu Hautverletzungen an den Händen bei Suiziden [5,9,13,14,18], wobei das Verletzungsmuster in nur 2 Artikeln näher erläutert wird [5,18]. Die beschriebenen Verletzungen haben jedoch die Gemeinsamkeit, dass sie als nichtintentionale, also akzidentielle Verletzungen zu werten sind, die am ehesten durch den ungeschickten Gebrauch eines Tatwerkzeugs (Messer etc.) zu erklären sind. ...
Es werden hier 2 Fälle von Suiziden durch scharfe Gewalt mittels Messer beschrieben und diskutiert. Diese Variante der Selbsttötung ist an sich nicht ganz selten; die Suizidenten hatten sich jedoch beim Zufügen der Stichverletzungen durch Griff in die Messerklinge akzidentielle Verletzungen an den Händen zugezogen, die als aktive Abwehrverletzungen fehlinterpretiert wurden, sodass zunächst von einem Tötungsdelikt ausgegangen werden musste. Die außergewöhnlichen Befunde werden vorgestellt und diskutiert.
Self-inflicted injury/self-directed violence is a vast topic that is complex and multi-factorial. Various classification systems exist, and several categories based on the underlying motive(s) are proposed. Self-directed violence is seen in diverse clinical fields. The medico-legal importance in the assessment of injuries is to assist in establishing the underlying manner in which they were sustained. To assist in the determination of self-inflicted injury, “typical” injury patterns have been described; however, “atypical” injuries does not preclude such a diagnosis. A comprehensive history, examination, and ancillary investigations are required in the assessment of self-inflicted injuries.
Forensic pathology and forensic anthropology are inherently related fields. The observations made during the autopsy and the conclusions from the anthropological analysis highlight the complementarities between the two approaches. In this review, gunshot wounds, sharp force injuries, chop wounds, blunt trauma, burned bodies, mechanical asphyxia and dismemberment will be analyzed from both perspectives. The result of this systematic review is that the conclusions stemming from the presence or absence of bone injuries must be very cautious because the observation of severe bone lesions does not always mean that this trauma was the cause of death; conversely, traumatic death, and even homicide, can be associated with a complete absence of bone lesions.
