The frequently dismissed importance of properly sampling skin bruises

Leg Med (Tokyo). 2021 May:50:101867. doi: 10.1016/j.legalmed.2021.101867. Epub 2021 Feb 23.

Abstract

The correct interpretation of skin lesions is a crucial issue in forensic medicine. Many macroscopic and microscopic vital reaction markers and molecules have been studied in the past years in order to estimate the timing of injuries. However, literature lacks information regarding how to perform sampling to obtain a more reliable and accurate response. The present study investigates 25 bruises and analyses the different histological asset in different areas (central or marginal) and the different layers (epidermis, dermis, hypodermis and muscle) of the wound. All wounds were sampled in several areas and analysed under a 200× magnification optical microscope, simply counting the degree of haemorrhaging (i.e hematic infiltration) visible in each optical field (0 = 0%-5%; 1 = 6%-25%; 2 = 26%-50%; 3 = 51%-75%; 4 = 76%-100%). All the injuries presented some kind of infiltration in at least one area, nonetheless only 56% of the wounds were infiltrated in the entirety of the areas. Finally, in 28% the dermal layer did not show any trace of infiltration. Therefore, considering such results it seems that depth or area of sampling of a bruise may largely influence the evaluation of vitality and hence of age of a wound. Though this may seem intuitive, no studies have examined this issue in depth.

Keywords: Blood infiltration; Bruises; Forensic pathology; Forensic science; Skin lesions.

MeSH terms

  • Contusions*
  • Forensic Pathology
  • Hemorrhage
  • Humans
  • Skin* / injuries
  • Specimen Handling