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Q. Define Injury and Wound. Discuss medico legal classifications of Injury and Wound. State the differences between Simple, grievous, and dangerous injury. How is the nature of Injury determined? What are the characteristics of Accidental, Homicidal, and Suicidal Wounds? How can they be differentiated? What do you understand by accident? What are the characteristics of Accidental Wound. Explain its medico legal aspects briefly. Which kind of injuries happen in Vehicular accidents? Differentiate between in incisive and lacerated wounds.

Injury and Wound

A wound is the term given to tissue damage caused by mechanical force. It is the forcible solution of continuity by mechanical force or any of the tissues of the body including the skin, mucous membrane, or cornea. This includes wounds caused by stabbing, blunt trauma (punching, kicking, beating etc), strangling, biting, shooting, falling from a height, being hit by a vehicle, and blast trauma from explosives.  In legal medicine, the word Wound means all lesions of the body and also includes bruises, contusions, fractures, dislocations, and the like. In general, to make a wound, in criminal cases, there must be an injury to the person by which any kind of tissue is broken.

Injury is as a result of an accident, fighting or when one is hurt while doing something. For example injury while playing or injuries in a bomb blast. Wound is when one is hurt with a weapon, especially a knife or a gun shot.

The word "injury" also has specific legal connotations as given in Section 44 of IPC, which says: The word "injury" denotes any harm whatever illegally caused to any person, in body, mind, reputation or property.  Thus, all wounds are injuries but all injuries may not be wounds.

Descriptions of wounds must include:
  1. the nature of the wound, ie whether it is a bruise, abrasion or laceration etc
  2. the wound dimensions, eg length, width, depth etc. It is helpful to take a photograph of the wound with an indication of dimension (eg a tape measure placed next to the wound), and for measurements to be taken of the wound as it appears first, and then with wound edges drawn together (if it is a laceration etc).
  3. the position of the wound in relation to fixed anatomical landmarks, eg distance from the midline, below the clavicle etc
  4. the height of the wound from the heel (ie ground level) - this is particularly important in cases where pedestrians have been struck by motor vehicles

Medical Classification of Wounds
  1. abrasions - loss of the superficial epithilial layer of the skin and do not leave a scar after healing.
  2. bruises/ contusions / haematomas - blow from a blunt weapon such as lathi. caused due to rupture of small subcutaneous blood vessels, called ecchymosis. e.g. black eye
  3. lacerations - tears or splits produced by blows from blunt objects e.g fall on hard surface, machinery, railway accidents, claws or teeth of animal, edges are irregular with surrounding abrasion, deeper tissues are torn 
  4. incised/slash wounds - orderly solution of skin and tissue by sharp cutting instruments such as knife, razor, scissors.
  5. perforating
  6. punches
  7. kicks
  8. bite marks
  9. defense injuries
Legal Classification of Wounds
  1. Simple - one which is neither extensive or serious and which heals rapidly without leaving any permanent disfigurement or deformity.
  2. Grievous - one which are covered under S. 320 of IPC - emasculation, permanent privation of the sight or either eye, ear,  privation of any joint, permanent impairing of the powers of any member or joint, permanent disfigurement of head or face, fracture or dislocation of a bone or tooth, any hurt which endangers life or which causes the sufferer during the space of 20 days in sever bodily pain or unable to follow his ordinary pursuits.
  3. Fatal - extensive and implicate important structures or organs so that they prove fatal.

Accidental Wounds Homicidal Wounds Suicidal Wounds
May or may not be self inflicted
Situation and Character clothes are damaged, room is disturbed Usually incised, punctured, or gunshot, clothes are not damaged, in closed room
Number, may be multiple in any direction Usually single shot or multiple linear and parallal
Direction and extent deep at beginning and superficial at end Slightly angled upwards, superficial at beginning and deep at end
Location anywhere usually on front, especially on chest, throat, wrist or temple
Weapon Location usually absent clenched in hands
Surrounding evidence Struggle suicide note
Defensive cuts present
Hesitant or Tentative cuts present

Wounds in Vehicular Accidents
Site of impact
direction of impact
force of impact
design of vehicle
behavior of vehicle
ejection of victim
supervening factor such as fire
Pedestrain Injuries
Occupants Injuries
Primary Impact
Secondary Impact