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Scheme for Investigating Cases Involving Firearms
Published in Paul T. Jayaprakash, Crime Scene Investigation and Reconstruction, 2023
The possibility of accident as the manner in gunshot wound has to be concluded on the basis of a comprehensive study of the crime scene circumstances. For more details on wound characteristics, readers may refer authors like DiMaio (1999) and Dodd (2005).
Management of Laryngotracheal Trauma
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Penetrating laryngotracheal injuries can cause varying degrees of damage depending on the location and the nature of the weapon used. Injury to neurovascular and soft-tissue structures can result in oedema, inflammation, haemorrhage, scarring and anatomical disruption. Gunshot wounds tend to cause a broad spectrum of damage, whereas stab wounds follow a more predictable course of injury.
Scalp, facial and gunshot injuries
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Surface injuries are central to forensic medicine. The pattern of injury provides information on the mechanism of causation of both external and internal injuries. Although this chapter deals predominantly with injuries to the scalp and face, it should be remembered that clues to the causation of injury may be present on other parts of the body. A systematic approach should be made to recording injuries, including type, dimensions, shape and colour, with the anatomical position, which can be linked to appropriate anatomical landmarks. Medical descriptions of wounds and injuries can be at variance with how legal systems define wounds. Gunshot wounds are lacerations with specific patterns of injury and are dealt with under a separate section in this chapter. As the effects of penetrating injuries are intrinsically linked to the surface injuries, this chapter also includes the effects of penetrating trauma.
Incidence and severity of asymptomatic ocular injury in adult and pediatric orbital fractures
Published in Orbit, 2023
Tyler Etheridge, Ben J. Brintz, Michael S. Jensen, Esteban Peralta, Azraa Ayesha, Abigail Jebaraj, Douglas P. Marx
The most common mechanism of injury were falls (24.0%), assault (22.2%), and motor vehicle accidents (14.8%). Two hundred and ninety-seven (19.4%) patients had another mechanism of injury, with scooter accident (n = 16), skiing accident (n = 13), and sports-related injury (n = 11) being the most common (Supplemental Table 1). We used the Cochran-Armitage test for trend to assess for changing proportion of patients, not necessarily increasing, with each mechanism of injury versus the others across the levels of injury severity. As demonstrated in Figure 2, the severity of injury increased with gunshot wounds (p-value <.001). We noted a trend toward decreased injury severity with falls, but this did not reach statistical significance (p-value = .06).
Saving Lives with Tourniquets: A Review of Penetrating Injury Medical Examiner Cases
Published in Prehospital Emergency Care, 2020
C. Bonk, B.W. Weston, C. Davis, A. Barron, O. McCarty, S. Hargarten
A total of 1,804 homicide cases were reviewed with an average of 120 homicides per year (Figure 1). The majority of deaths were from penetrating injuries (84.3%), and most were younger (mean age: 31 years), male (84.5%), and African-American (73.8%) (Table 1). Moreover, gunshot wounds (1,366; 89.8%) were the most common mechanism type of injury, followed by stab wounds (151; 9.9%). Isolated penetrating extremity wounds accounted for 22 of the penetrating injury cases (1.45%), while concurrent extremity and central injuries accounted for an additional 409 (26.9%) of the cases (Table 2). Of these concurrent extremity and central injuries, 13 (3.2%) had the extremity injury as the likely cause of death. Among all extremity injuries in this multiple injury group, 404 (92.2%) were deemed amenable to tourniquet placement (Table 3), including all 22 of the isolated extremity injuries.
Topical negative-pressure wound therapy: emerging devices and techniques
Published in Expert Review of Medical Devices, 2020
Raymund E. Horch, Ingo Ludolph, Wibke Müller-Seubert, Katharina Zetzmann, Theresa Hauck, Andreas Arkudas, Alexander Geierlehner
In the late 20th century, increasing knowledge on wound healing mechanisms led to the invention of a sealed drainage system for surface wounds [14–16]. Continuous negative pressure as an adjunct to such a system enabled sub-atmospheric conditions in a moist wound environment [17]. The initial rationale behind this invention was to improve serum drainage and to ensure adherence to skin flaps [18]. Its application on infectious wounds a few years later showed that negative pressure can improve infection control, thus help the wound healing process in a moist environment [19,20]. Problems researchers had to face at that time were the maintenance of a continuous negative pressure and a controlled elimination of wound exudate. Conventional suction devices such as Redon flasks, as initially used by Fleischmann et al., could not provide constant negative pressure [21]. It rather showed a logarithmic decline of pressure over time with initially very high values toward very low values at the end [22]. The lack of constant sub-atmospheric pressure to a wound disqualified such suction devices being used as NPWT. Wall suctions were principally feasible but posed another problem. The uncontrolled removal of blood from patients following gunshot wounds made this problem evident. This led to the invention of a computer-controlled device that would fit all necessary regulatory preconditions to render this therapy modality safe and reproducible.