Why Is It Important to Study the Type of Wounds in Legal Medicine

Why Is It Important to Study the Type of Wounds in Legal Medicine

37. Kondo T, Tanaka J, Ishida Y, Mori R, Takayasu T, Ohshima T. Ubiquitin expression in skin wounds and its application for forensic determination of wound age. Int J Legal Med. (2002) 116:267–72. DOI: 10.1007/S00414-002-0322-Y 71. Kubo H, Hayashi T, Ago K, Ago M, Kanekura T, Ogata M. Forensic diagnosis of ante- and post-mortem burns based on aquaporin-3 gene expression in the skin. Leg Med. (2014) 16:128-34.

doi: 10.1016/j.legalmed.2014.01.008 78. Legaz I, Pérez-Cárceles MD, Gimenez M, Martínez-Díaz F, Osuna E, Luna A. Immunohistochemistry as a tool to characterize human skin wounds from sagging spots. Rome J Leg Med. (2018) 26:354-8. doi: 10.4323/RJLM.2018.354 65. Xu J, Zhao R, Xue Y, Xiao H, Sheng Y, Zhao D, et al. RNA-seq profiling shows differentially expressed genes as potential markers of vital responses in skin contusions: a pilot study. Forensic Sci Res. (2018) 3:153-60.

doi: 10.1080/20961790.2017.1349639 Forensic pathology is primarily concerned with the examination and assessment of persons injured or killed or suspected by external influences such as trauma or intoxication, but also of persons suspected of having injured another person. This means that not only victims and suspects, but also suicides and accidental deaths are examined by a forensic specialist. In contrast, people with non-fatal injuries after intentionally self-inflicted or accidental injury or intoxication are usually treated exclusively within the health care system. In many countries, forensic pathology is a medical specialty within the legal system, not the health system. Keywords: human skin wounds, omics sciences, vital injuries, forensic sciences, age wound 79. Hernández-Cueto C, Lorente JA, Pedal I, Villanueva E, Zimmer G, Girela E, et al. Cathepsin D as a vitality marker in human skin wounds. Int J Legal Med. (1993) 106:145–7. doi: 10.1007/BF01225236 All patients who are victims of physical or sexual assault, abuse or trauma have medico-legal needs.

When treating injuries without considering their medico-legal significance, emergency clinicians may misinterpret wounds, fail to recognize victims of abuse or domestic violence, and inadequately describe the physical appearance of wounds. During patient care, evidence that may be essential to criminal or civil proceedings may be lost, thrown away, or accidentally taken away,3 despite the Joint Commission`s requirements to “preserve evidence and assist in future legal proceedings.” Previous studies have shown that evidence can be inadvertently rejected during the initial assessment and violations are also not properly documented. 49. Kondo T, Ohshima T, Mori R, Guan DW, Ohshima K, Eisenmenger W. Immunohistochemical detection of chemokines in human skin wounds and their use to determine wound age. Int J Legal Med. (2002) 116:87–91. doi: 10.1007/s004140100260 The job is to act as a medical expert in justice matters, not to primarily assist either party in the process. Therefore, the role of the forensic pathologist in the relationship with the person being studied is obviously completely different from the role of the clinical physician in his or her relationship with the patient, where the physician often becomes the patient`s advocate. The main task of the forensic pathologist is to practice and transmit a scientific approach to medical issues raised in a legal context with death.

It is in the nature of things that the forensic pathologist, whatever its principle, strives to assist in impartial assessments based on “science and proven experience.” Although blunt wounds may not leave the same signs of penetration as a gunshot or knife wound, an experienced pathologist is still able to make conclusive decisions about trauma. The pathologist can determine if the injury was caused by a bruise (bruises or black and bruises), abrasion (mostly shaved skin), laceration (skin crack), fracture (broken bone) or hematoma (blood in tissues or body cavities). These experts not only assess the injury itself, but also examine the strength and extent of its inflictation, which leads to an assessment of the cause of injury or death. 51. Ishida Y, Kimura A, Nosaka M, Kuninaka Y, Shimada E, Yamamoto H, et al. Detection of endothelial progenitor cells in human skin wounds and their use for wound age determination. Int J Legal Med. (2015) 129:1049-54. doi:10.1007/s00414-015-1181-7 1. Maeda H, Ishikawa T, Michiue T. Forensic biochemistry for the functional study of death: concept and practical application.

Leg Med. (2011) 13:55–67. doi: 10.1016/j.legalmed.2010.12.005 Establishment of an African College of Forensic Medicine and Science to provide specialized training in medicine and forensic science in the African region; Forensic pathology refers to a field of study; not an individual. It can be defined as “a branch of medicine that applies the principles and knowledge of the medical sciences to problems in the field of law” (DiMaio & DiMaio, 2001, p. 1). Therefore, to be a practicing forensic pathologist, you must also be a physician. Calling oneself a forensic pathologist without a medical degree and certification in forensic pathology could be considered fraud, or even perjury, if sworn (e.g., affidavits and affidavits). 8. Langlois NE, Gresham GA.

Bruising aging: an examination and study of color changes over time. Forensic Sci Int. (1991) 50:227–38. doi: 10.1016/0379-0738(91)90154-B 4. Grellner W, Vielen S, Madea B. Transforming growth factors (TGF-α and TGF-β1) in the determination of vitality and wound age: immunohistochemical study on human skin wounds. Forensic Sci Int. (2005) 153:174–80. doi: 10.1016/j.forsciint.2004.08.021 55. Kondo T, Ohshima T, Eisenmenger W. Immunohistochemical and morphometric study on the temporal expression of interleukin-1α (IL-1α) in human skin wounds for forensic determination of wound age.

Int J Legal Med. (1999) 112:249–52. doi: 10.1007/s004140050244 38. Fieguth A, Franz D, Lessig R, Kleemann WJ. Fatal neck trauma: immunohistochemical examination of local lesions. Forensic Sci Int. (2003) 135:218–25. doi: 10.1016/s0379-0738(03)00210-x 29.

Betz P, Nerlich A, Tübel J, Wiest I, Hausmann R. Detection of cell death in human skin wounds of different ages by in situ final marking of nuclear DNA fragments. Int J Legal Med. (1997) 110:240–3. doi: 10.1007/s004140050078 Forensic medicine is increasingly used by judicial systems, even in countries where religious and cultural opposition to autopsies is strong. There are few, if any, countries in the world that do not perform autopsies for forensic purposes.