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Universal skin incision over the right shoulder's back and buttocks for posterior dissection during the autopsy
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Abstract Background Since the practice of conventional autopsy, one new method for skin incision as “fourth incision” has been added to the preexisting conventional methods of skin incisions, i.e., “I”/“Y”/modified “Y”. Reconstitution of conventional skin incisions leave visible defect (disfigurement) on the dead body which gets enhanced with invar...
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Rationale
Blinding reduces performance and detection bias in randomized controlled trials (RCT). There is evidence that lack of blinding leads to overestimation of treatment effects in pharmacological trials. Since surgical trials use interventions with a physical component, blinding is often complicated. The aim of this study was to analyze, in ge...
Citations
... Fourth and fifth incisions have been proposed for the best cosmetic appearance of the corpse, but they are recommended/valuable in cases of torture-related death and trauma on the back. 7,8 The practicality of performing these incisions in all cases is minimal as they are more time-consuming, with most of the autopsy centers already overloaded. In the present study, the authors propose a new incision, i.e., "Stethoscope" incision, in addition to a modified Y incision, which provides a good cosmetic appearance as the sutures were not visible in front of the neck and chest but were hidden posteriorly on the neck and in the chest present behind the anterior axillary fold. ...
Post autopsy reconstruction (PAR) plays a vital role in the external appearance of dead bodies while handing over to grieving family members. Autopsy surgeons should not only be restricted to autopsy findings/techniques but should also give importance to PAR. Autopsy incision includes various conventional incisions like I, Y, and Modified Y-shaped. The most commonly used incision is I -shaped in most of the autopsy because it is easy for quick suturing but it produces a poor cosmetic appearance because suturing produces visible suture over the front of the neck and chest of a corpse and improper suturing in the skin flaps leads to gapping causes leakage of body fluids at the suture site. More often that leads to avoidable, unnecessary emotional distress for grieving family members. That creates a negative image of forensic practice in society and sometimes with administrative complaints. The authors conducted an observation based study on the medicolegal autopsy that included ten cases that involved "Stethoscope" and various conventional incisions and explored suturing techniques and body packing methods. The study observed that the proposed "Stethoscope" incision was feasible, less time-consuming for suturing, had an excellent cosmetic effect, and was cost-effective. The suturing technique revealed that invisible sutures leads to good cosmetic outcomes but is more time-consuming and costly. The body packing method showed the excellent result of no leakage of body fluid from the suture site. The authors proposed a "Stethoscope" method of incision that can be practiced and adopted for a better cosmetic appearance and humanitarian aspect for grieving relatives. The body packing method renders the body non-hazardous to the public and attendants while handling and transporting. The authors highlight the importance and sensitization of autopsy surgeon/mortuary staff to restructure the corpse with the best cosmetic appearance for the Dignified Management of the Dead and Humanitarian Forensics.
... There are few more incisions, other than these three conventional incisions which are used by different autopsy surgeons as per convenience. Autopsy -What Do We Learn from Corpses? 6 ...
... Few authors also advised fifth or another incision [6] to reduce the time taken for suturing and disfigurement of the body of the deceased. The body is kept in a supine position with a block under the back of the chest to extend the neck. ...
The word autopsy is formed from two Greek words, Autos and Optos. The meaning of the word Autos is self and the word Optos is seen. Thus, autopsy means seeing of self. An autopsy is of two types. Medicolegal Autopsy and Histopathological or Clinical Autopsy. In this chapter, we mainly focus on the Medicolegal autopsy, what is the aim of the autopsy. What are the prerequisites of the autopsy? Where medicolegal autopsy can be carried out? Who can carry out the autopsy. What are the different incisions of doing a medico-legal autopsy? We also discuss which viscera are to persevere in different autopsy procedures and which trace elements are to be collected in common medicolegal autopsies. How viscera and trace evidence collected from the dead body are preserved. We will also discuss, in brief, the preservatives used.
One of the greatest sources of physical evidence is the dead body of the victim itself. A cadaver is a plethora of clues, that forensic scientists can investigate and reconstruct the circumstances surrounding the crime. Death can be defined as the permanent and irreversible cessation of functions of the three vital organs: the brain, the heart, and the lungs. Once an individual dies, the body undergoes certain orderly changes, that may be documented and used for the estimation of time passed since the individual’s death, also known as the post-mortem interval (PMI) (Shedge et al., Postmortem changes, StatPearls Publishing, Treasure Island, 2020). The investigation of a dead body involves examination at the scene of crime, autopsy or post-mortem examination, and determination of miscellaneous information such as the mode, manner, and cause of death. This chapter is divided into three parts: First, it discusses the examination of a dead body at the scene of the crime, the post-mortem examination and its documentation, and then the determination of miscellaneous information.
The autopsy is a specialized procedure in which a pathologist performs a thorough external and internal examination including dissection of the organs from different body cavities such as cranial, thoracic, abdominal, and pelvic. In such dissection of an intact dead body, disfiguration and destruction are likely. When viewed during a funeral service, the currently practiced conventional autopsy dissection techniques can result in minimal telltale autopsy marks on the body of the deceased, in exposed areas of the head and neck even when the other areas of the body are covered with clothing. We propose a modification to the conventional skin incision over the head and neck in a way that the incision is placed over the back of the head and neck compared to the conventional incision over the sides of the head and sides of the neck. In this way, the incisions and their stitch marks are hidden, making them cosmetically sound. Although the exposure gained through the proposed method is similar to the conventional method additional incisions over the back of the neck with the additional turning of the body from supine to prone can increase the time duration of the autopsy compared to the conventional method. Moreover, in this method, the incisions are invisible even in a bold-headed deceased as the head incision is placed over the back.
