(8) Abrasions, Lacerations, Incisions and Penetrating Wounds

Abrasions

Resulting from friction of the skin against a firm object causing removal of the epidermis (outermost layer of skin)

Excision

An area from which something has been cut out

Excise

To remove by cutting

Mastic Compound

Putty like substance absorbent sealing adhesive that can be injected under the skin or applied to the surface tissues to establish skin contour

How do abrasions vary in size and depth?

-SMall and shallow, as from a fall
-Deeper and extensive as from dragging during a car crash and may also contain lacerations within the abrasion

The length between the abrasion and death affects:

-Amount of dehydration
-THe color of the abrasion
-The amount of scabbing

What are the treatments for non viewable abrasions?

-Embalm
-Seal abrasions with a sealer
-Cover with cotton
-Determine if plastic wrap or plastic garments are necessary (abrasions tend to be very dry wounds)

What are the treatment options for viewable abrasions?

-Before embalming, cover the area surrounding the abrasion with massage cream (but not to the abrasion itself)
-Embalm
-Remove scabs after embalming
-Dry the area using a cauterizing agent
-Seal with a liquid sealer
-Add wax, recreating pores and facial markings
-Cosmetize- abrasions are often very dark and may need cosmetic treatment prior to applying wax

Laceration

Irregularly torn/jagged wound. Vary in length, depth, width and tissue damage. Typically caused by blunt force trauma

Incision

Cleanly cut (even margins) wound. Vary in length and width. Typically caused bya sharp object such as a scalpel blade or a piece of glass or sharp metal

How should lacerations and incisions be treated below the skin’s surface?

Drying, packing, suturing and sealing the wounds.
-Prior to embalming, determine if bridge sutures are necessary

What suture do you use for a laceration on/near the skin surface?

Worm suture in visible areas

What suture do you use for an incision on/near the skin surface?

Intradermal suture in visible areas

How should you treat incisions/lacerations in viewable areas?

-Dry inside of wound with cauterant
-Add massage cream to surrounding areas
-Bridge stitch where necessary
-Embalm
-Dry wound, retreat with cauterant pack if necessary and add sealer internally to deep tissues
-Pack with drying/incision powders
-Excise dried and dehydrated edges of wound
-Suture appropriately
-Wax, if needed, recreating pores and facial markings
-Cosmetize as needed

What are penetrating wounds?

Wounds entering the interior of an organ or cavity.
-EX: Bullet entries/exits
-Medical devices (feeding tubes)
-Punctures
-Stab wounds
-Can vary in size from very small to very large, requiring minimal restoration to large cavity restorations

What is a puncture?

Hole from a piercing injury

What are the pre-embalming treatments for punctures?

-Remove scabs using a sharp instrument
-cover the area with an emollient

What are the post embalming treatments for punctures?

-Excise dehydrated margins
-Ensure firm, dry tissue
-Close the opening appropriately (depends on visibility)
-Wax if necessary
-Cosmetize if necessary

A rifle is a ____ weapon

HIgh velocity
(longer barrels create faster moving bullets)

A pistole is a ____ weapon

Lower velocity

Are wounds more severe at a closer or long range?

close

Bullets can _____ inside the body, damaging the circulatory system and/or internal organs

Ricochet

What is the difference between an entrance and exit wound?

Entrance is smaller and cleaner, the exit is larger and lacerated

What can you expect of gunshot wounds?

-swollen and/or discolored eyes
-fractured bones

What are the pre-embalming procedures for GSW?

-Face is covered with an emollient (lanolin spray/massage cream)
-Surface bleach ecchymosis around the eyes)
-Cold compresses for swelling

What is the embalming treatment for GSWs?

Leave wounds open and observe distribution

What are the post embalming procedures for GSWs?

-Excise dehydrated margins
-Ensure firm, dry tissue
-Large, deep wounds are treated as large cavity restorations
-Small wounds MAY be sutured
-Some wounds may need waxing, done over firm dry tissue
-Treat remaining discolorationss (such as powder burns and black eyes)