Skip to main content

Abstract

A wound is defined as an injury to the surface of the body, “caused by a cut, blow, hard or sharp impact etc., especially one in which the skin is cut or broken; an external injury.”1. In practice, to the medical practitioner, the terms wound and injury are synonymous but strictly the legal definition of a wound involves breaking of the full thickness of the skin. An incision is a division made by cutting and a cut is defined as a long, narrow opening in a surface, especially the skin, made by something sharp; an incision, a gash. The verb to cut means to penetrate or wound with a sharp-edged implement1 and therefore cuts/incisions are sharp force injuries. To stab is to wound or kill a person by a thrust with the point of a knife (or other weapon)1 and although it is accepted that fatal stabbing can result from penetration of the body by a blunt weapon, the majority of such cases, certainly in the UK, are caused by sharp-edged weapons, principally knives. Therefore, most (but not all) stab wounds are a form of incised wound.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. The New Shorter Oxford English Dictionary. Oxford: Clarendon Press, 1993.

    Google Scholar 

  2. Karger B, Niemeyer J, Brinkmann B. Suicides by sharp force: typical and atypical features. Int J Legal Med 2000;113:259–62.

    PubMed  CAS  Google Scholar 

  3. Start RD, Milroy CM, Green MA. Suicide by self-stabbing. For Sci Int 1992;56:89–94.

    CAS  Google Scholar 

  4. Karger B, Rothschild MA, Pfeiffer H. Accidental sharp force fatalities — beware of architectural glass, not knives. For Sci Int 2001;123:135–9.

    CAS  Google Scholar 

  5. Criminal Statistics England and Wales, 1999. HMSO.

    Google Scholar 

  6. Office for National Statistics, Mortality Statistics. Review of the Registrar General on Deaths in England and Wales, 1998 (Table 7. Death rates per 1,000,000 population). London: The Stationery Office.

    Google Scholar 

  7. Scottish Executive Central Research Unit (1999), Homicide in Britain. Edinburgh: The Stationery Office.

    Google Scholar 

  8. Scottish Executive (1999) Statistical Bulletin. Criminal Justice Series. Homicide in Scotland 1998. Government Statistical Service.

    Google Scholar 

  9. Bleetman A, Perry CH, Crawford R, Swann IJ. Effect of Strathclyde Police initiative “Operation Blade” on accident and emergency attendances due to assault. J Accid Emerg Med 1997;14:153–6.

    PubMed  CAS  Google Scholar 

  10. Karlsson T. Sharp-force homicides in the Stockholm area, 1983–1992. For Sci Int 1998;94:129–39.

    CAS  Google Scholar 

  11. Karlsson T, Ormstad K, Rajs J. Patterns in sharp force fatalities — a comprehensive forensic medical study: Part 2. Suicidal sharp force injury in the Stockholm area, 1972–1984. J Forensic Sci 1988;33:448–61.

    PubMed  CAS  Google Scholar 

  12. Watanabe T, Kobayashi Y, Hata S. Harakiri and suicide by sharp instruments in Japan. Forensic Sci 1973;2:191–9.

    PubMed  CAS  Google Scholar 

  13. Byard RW, Klitte A, Gilbert JD, James RA. Clinicopathologic features of fatal self-inflicted incised and stab wounds. A 20-year study. Am J For Med Path 2002;23:15–18.

    Google Scholar 

  14. Sperry K, Campbell HR. An elliptical incised wound of the breast misinterpreted as a bite injury. J Forensic Sci 1990;35:1226–35.

    PubMed  CAS  Google Scholar 

  15. Milroy CM, Rutty GN. If a wound is “neatly incised” it is not a laceration. BMJ (letter) 1997;315:1312.

    CAS  Google Scholar 

  16. Ciallella C, Caringi C, Aromatario M. Wounds inflicted by survival knives. For Sci Int 2002;126:82–7.

    CAS  Google Scholar 

  17. Shepherd JP, Shapland M, Pearce NX, Scully C. Pattern, severity and aetiology of injuries in victims of assault. J Roy Soc Med 1990;83:75–8.

    PubMed  CAS  Google Scholar 

  18. Shepherd JP, Price M, Shenfine P. Glass abuse and urban licensed premises. J Roy Soc Med (letter) 1990:83;276–7.

    CAS  Google Scholar 

  19. Karlsson T. Homicidal and suicidal sharp force fatalities in Stockholm, Sweden. Orientation of entrance wounds in stabs gives information in the classification. For Sci Int 1998;93:21–32.

    CAS  Google Scholar 

  20. Kuroda N, Saito K, Takada A, Watanabe H, et al., Suicide by self-stabbing in the city of Toky — a review of accumulated data from 1976 to 1995. Jap J Leg Med 1997;51:301–6.

    PubMed  CAS  Google Scholar 

  21. Di Nunno N, Costantinides F, Bernasconi P, Di Nunno C. Suicide by hara-kiri. A series of four cases. Am J For Med Path 2001;22:68–72.

    Google Scholar 

  22. Betz P, Tutsch-Bauer E, Eisenmenger W. “Tentative” injuries in a homicide. Am J For Med Path 1995;16:246–8.

    CAS  Google Scholar 

  23. Herbst J, Haffher H-Th. Tentative injuries to exposed skin in a homicide case. For Sci Int 1999;102:193–6.

    CAS  Google Scholar 

  24. Di Maio DJ, Di Maio VJM (Eds). Forensic pathology. New York: Elsevier, 1989.

    Google Scholar 

  25. Purdue BN. Cutting and piercing wounds. In: Mason JK, Purdue BN, editors. The pathology of trauma, 3rd edn. London: Arnold, 2000.

    Google Scholar 

  26. Katkici U, Ozkok MS, Orsal M. An autopsy evaluation of defence wounds in 195 homicidal deaths due to stabbing. J Forensic Sci Soc 1994;34:237–40.

    PubMed  CAS  Google Scholar 

  27. Hunt AC, Cowling RJ. Murder by stabbing. For Sci Int 1991;52:107–12.

    CAS  Google Scholar 

  28. Rogde S, Hougen H.P, Poulsen K. Homicide by sharp force in two Scandinavian capitals. For Sci Int 2000;109:135–45.

    CAS  Google Scholar 

  29. Rouse DA. Patterns of stab wounds: a six-year study. Med Sci Law 1994;34:67–71.

    PubMed  CAS  Google Scholar 

  30. Spitz WU. Sharp force injury. In:Spitz WU, editor. Medicolegal investigation of death, 3rd edn. Illinois: CC Thomas, 1993, Ch. VIII.

    Google Scholar 

  31. Hirt M, Karger B. Fatal brain injury caused by the free-flying blade of a knife — case report and evaluation of the unusual weapon. Int J Legal Med 1999;112:313–14.

    PubMed  CAS  Google Scholar 

  32. Rothschild MA, Karger B, Schneider V. Puncture wounds caused by glass mistaken for stab wounds with a knife. For Sci Int 2001;121:161–5.

    CAS  Google Scholar 

  33. Webb E, Wyatt JP, Henry J, Busuttil A. A comparison of fatal with non-fatal knife injuries in Edinburgh. For Sci Int 1999;99:179–87.

    CAS  Google Scholar 

  34. Ormstad K, Karlsson T, Enkler L, Law B, Rajs J. Patterns in sharp force fatalities — a comprehensive forensic medical study. J Forensic Sci 1986;31:529–42.

    PubMed  CAS  Google Scholar 

  35. O’Callaghan PT, Jones MD, James DS, Leadbeatter S, Evans SL, Nokes LDM. A biomechanical reconstruction of a wound caused by a glass shard — a case report. For Sci Int 2001;117: 221–31.

    Google Scholar 

  36. Lambrianides AL, Rosin RD. Penetrating stab injuries of the chest and abdomen. Injury 1984;15:300–3.

    PubMed  CAS  Google Scholar 

  37. Kieck CF, De Villiers JC. Vascular lesions due to transcranial stab wounds. J Neurosurg 1984;60:42–6.

    PubMed  CAS  Google Scholar 

  38. Deb S, Acosta J, Bridgeman A, Wang D, Kennedy S, Rhee P. Stab Wounds to the head with intracranial penetration. J Trauma: Injury, Infection and Critical Care 2000;48:1159–62.

    CAS  Google Scholar 

  39. Lettington W. Stabbing to right temple with partial knife blade retention: differentiating stab from slash wound. J Clin For Med 2000;7:45–7.

    Google Scholar 

  40. Murray LA, Green MA. Hilts and knives: a survey of ten years of fatal stabbings. Med Sci Law 1987;27:182–3.

    PubMed  CAS  Google Scholar 

  41. Thoresen SO, Rognum TO. Survival time and acting capability after fatal injury by sharp weapons. For Sci Int 1986;31:181–7.

    CAS  Google Scholar 

  42. Levy V, Rao VJ. Survival time in gunshot and stab wound victims. Am J For Med Path 1988;9:215–17.

    CAS  Google Scholar 

  43. Demetriades D. Cardiac wounds. Experience with 70 patients. Ann Surg 1986;203:315–17.

    PubMed  CAS  Google Scholar 

  44. West I. Single suicidal stab wounds — a study of three cases. Med Sci Law 1981;21:198–201.

    PubMed  CAS  Google Scholar 

  45. Gojanovic MD. Homosexual homicides. J Clin For Med 1998;5:191–4.

    Google Scholar 

  46. Bell MD, Vila RI. Homicide in homosexual victims. Am J For Med Path 1996;17:65–9.

    CAS  Google Scholar 

  47. R v Cook (1982) Crim LR 670.

    Google Scholar 

  48. Byard RW, Gilbert JD, James RA. Traditional punishment and unexpected death in Central Australia. Am J For Med Path 2001;22:92–5.

    CAS  Google Scholar 

  49. Boyle EM, Maier RV, Salazar JD, et al. Diagnosis of injuries after stab wounds to the back and flank. J Trauma: Injury, Infection & Critical Care 1997;42:260–5.

    Google Scholar 

  50. Ivatury RR, Prakashchandra MR, Nallathambi M, Gaudino J, Stahl WM. Penetrating gluteal injuries. J Trauma 1982;22:706–9.

    PubMed  CAS  Google Scholar 

  51. Mercer DW, Buckman RF, Sood R, Kerr TM, German J. Anatomic considerations in penetrating gluteal wounds. Arch Surg 1992;127:407–10.

    PubMed  CAS  Google Scholar 

  52. Fekete JF, Fox AD. Successful suicide by self-inflicted multiple stab wounds of the skull, abdomen and chest. J Forensic Sci 1980;25:634–7.

    PubMed  CAS  Google Scholar 

  53. Cox HT. The cleavage lines of the skin. Br J Surg 1941;29:234–40.

    Google Scholar 

  54. Bleetman A, Dyer J. Ultrasound assessment of the vulnerability of the internal organs to stabbing: determining safety standards for stab-resistant body armour. Injury, Int J Care Injured 2000;31:609–12.

    CAS  Google Scholar 

  55. Connor SE, Bleetman A, Duddy MJ. Safety standards for stab-resistant body armour: a computer tomographic assessment of organ to skin distances. Injury 1998;29:297–9.

    PubMed  CAS  Google Scholar 

  56. Knight B. The dynamics of stab wounds. Forensic Science 1975;6:249–55.

    PubMed  CAS  Google Scholar 

  57. Knight B (ed). Forensic pathology, 2nd edn. London: Arnold, 1996.

    Google Scholar 

  58. Green MA. Stab wound dynamics — a recording technique for use in medico-legal investigations. J Forensic Sci Soc 1978;18:161–3.

    PubMed  CAS  Google Scholar 

  59. Jones S, Nokes L, Leadbeatter S. The mechanics of stab wounding. For Sci Int 1994;67:59–63.

    CAS  Google Scholar 

  60. Miller SA, Jones MD. Kinematics of four methods of stabbing: a preliminary study. For Sci Int 1996;82:183–90.

    CAS  Google Scholar 

  61. Chadwick EKJ, Nicol AC, Lane JV, Gray TGF. Biomechanics of knife stab attacks. For Sci Int 1999;105:35–44.

    CAS  Google Scholar 

  62. Chadwick EKJ, Nicol AC, Floyd S, Gray TGF. A telemetry-based device to determine the forcedisplacement behaviour of materials in high-impact loading situations. J Biomechanics 2000;33:361–5.

    CAS  Google Scholar 

  63. Horsfall I, Prosser PD, Watson CH, Champion SM. An assessment of human performance in stabbing. For Sci Int 1999;102:79–89.

    CAS  Google Scholar 

  64. PSDB Stab-resistant body armour test procedure. Home Office Science and Technology Group, 1993.

    Google Scholar 

  65. O’Callaghan PT. The biomechanics of stab wounds. Ph.D. Thesis. Cardiff University, 1999.

    Google Scholar 

  66. Monahan DL, Harding HWJ. Damage to clothing — cuts and tears. J Forensic Sci 1990;35:901–12.

    Google Scholar 

  67. Costello PA, Lawton ME. Do stab cuts reflect the weapon which made them? J Forensic Sci Soc 1990;30:89–95.

    Google Scholar 

  68. Taupin JM. Comparing the alleged weapon with damage to clothing — the value of multiple layers and fabrics. J Forensic Sci 1999;44:205–7.

    PubMed  CAS  Google Scholar 

  69. Rao VJ, Hart R. Tool mark determination in cartilage of stabbing victim. J Forensic Sci 1983;28:794–9.

    PubMed  CAS  Google Scholar 

  70. Taff ML, Boglioli LR. Science and politics of cutting and stabbing injuries in the USA. J Clin For Med 1998;5:80–4.

    CAS  Google Scholar 

  71. Asensio JA, Murray J, Demetriades D, et al. Penetrating cardiac injuries: A prospective study of variables predicting outcomes. J Am Coll Surg 1998;186:24–34.

    PubMed  CAS  Google Scholar 

  72. Trinkle JK. Penetrating heart wounds: Difficulty in evaluating clinical series. Ann Thorac Surg 1984;38:181–2.

    PubMed  CAS  Google Scholar 

  73. Demetriades D, van der Veen BW. Penetrating injuries of the heart: Experience over two years in South Africa. J Trauma 1983;23:1034–41.

    PubMed  CAS  Google Scholar 

  74. Sugg WL, Rea WJ, Ecker RR, Webb WR, Rose EF, Shaw RR. Penetrating wounds of the heart. An analysis of 459 cases. J Thorac Cardiovasc Surg 1968;56:531–45.

    PubMed  CAS  Google Scholar 

  75. Oakland C, Vivien J. Penetrating cardiac injuries. BMJ (letter) 1987;295:502.

    CAS  Google Scholar 

  76. Campbell NC, Thomson SR, Muckart DJJ, Meumann CM, van Middelkoop I, Botha JBC. Review of 1,198 cases of penetrating cardiac trauma. Br J Surg 1997;84:1737–40.

    PubMed  CAS  Google Scholar 

  77. Naughton MJ, Brissie RM, Bessey PQ, McEachern MM, Donald JM, Laws HL. Demography of penetrating cardiac trauma. Ann Surg 1989;209:676–81.

    PubMed  CAS  Google Scholar 

  78. Henderson VJ, Smith S, Fry WR, et al. Cardiac Injuries: Analysis of an unselected series of 251 cases. J Trauma 1994;36:341–8.

    PubMed  CAS  Google Scholar 

  79. Baker JM, Battistella FD, Kraut E, Owings JT, Follette DM. Use of cardiopulmonary bypass to salvage patients with multiple-chamber heart wounds. Arch Surg 1998;133:855–60.

    PubMed  CAS  Google Scholar 

  80. Thourani VH, Feliciano DV, Cooper WA, et al. Penetrating cardiac trauma at an urban trauma center: A 22-year perspective. Am Surgeon 1999;65:811–18.

    PubMed  CAS  Google Scholar 

  81. Velmahos GC, Degiannis E, Souter I, Saadia R. Penetrating trauma to the heart: A relatively innocent injury. Surgery 1994;115:694–7.

    PubMed  CAS  Google Scholar 

  82. Marshall WG, Bell JL, Kouchoukos NT. Penetrating cardiac trauma. J Trauma 1984;24: 147–9.

    PubMed  Google Scholar 

  83. Asensio JA, Berne JD, Demetriades D, et al. One hundred five penetrating cardiac injuries: A 2 year prospective evaluation. J Trauma: Injury, Infection & Critical Care 1998; 44:1073–82.

    CAS  Google Scholar 

  84. Ivatury RR, Rohman M, Steichen FM, Gundez Y, Nallathambi M, Stahl WM. Penetrating cardiac injuries: Twenty-year experience. Am Surgeon. 1987;53:310–17.

    PubMed  CAS  Google Scholar 

  85. Attar S, Suter CM, Hankins JR, Sequeira A, McLaughlin JS. Penetrating cardiac injuries. Ann Thorac Surg 1991;51:711–16.

    PubMed  CAS  Google Scholar 

  86. Harris DG, Papagiannopoulos KA, Pretorius J, Van Rooyen T, Rossouw GJ. Current evaluation of cardiac stab wounds. Ann Thorac Surg 1999;68:2119–22.

    PubMed  CAS  Google Scholar 

  87. Arreola-Risa C, Rhee P, Boyle EM, Maier RV, Jurkovich GG, Foy HM. Factors influencing outcome in stab wounds of the heart. Am J Surg 1995;169:553–6.

    PubMed  CAS  Google Scholar 

  88. Mittal V, McAleese P, Young S, Cohen M. Penetrating cardiac injuries. Am Surgeon 1999; 65:444–8.

    PubMed  CAS  Google Scholar 

  89. Tyburski JG, Astra L, Wilson RF, Dente C, Steffes C. Factors affecting prognosis with penetrating wounds of the heart. J Trauma: Injury, Infection & Critical Care 2000;48:587–91.

    CAS  Google Scholar 

  90. Brown SE, Gomez GA, Jacobson LE, Scherer T, McMillan RA. Penetrating chest trauma: Should indications for emergency room thoracotomy be limited? Am Surgeon 1996;62:530–4.

    PubMed  CAS  Google Scholar 

  91. Craig R, Clarke K, Coats TJ. On-scene thoracotomy: a case report. Resuscitation 1999;40:45–7.

    PubMed  CAS  Google Scholar 

  92. Coats TJ, Keogh S, Clark H, Neal M. Prehospital resuscitative thoracotomy for cardiac arrest after penetrating trauma: Rationale and case series. J Trauma: Injury, Infection 8c Critical Care 2001;50:670–3.

    CAS  Google Scholar 

  93. Moreno C, Moore EE, Majure JA, Hopeman AR. Pericardial tamponade: A critical determinant for survival following penetrating cardiac wounds. J Trauma 1986;26:821–5.

    PubMed  CAS  Google Scholar 

  94. Leppaniemi AK, Voutilainen PE, Haapiainen RK. Indications for early mandatory laparotomy in abdominal stab wounds. Br J Surg 1999;86:76–80.

    PubMed  CAS  Google Scholar 

  95. Lee WC, Uddo JF, Nance FC. Surgical judgement in the management of abdominal stab wounds. Ann Surg 1984;199:549–54.

    PubMed  CAS  Google Scholar 

  96. Asensio JA, Chahwan S, Hanpeter D, et al. Operative management and outcome of 302 abdominal vascular injuries. Am J Surg 2000;180:528–34.

    PubMed  CAS  Google Scholar 

  97. Byrne DE, Pass HI, Crawford FA. Traumatic vena caval injuries. Am J Surg 1980;140:600–2.

    PubMed  CAS  Google Scholar 

  98. Starzl TE, Kaupp HA, Beheler EM, Freeark RJ. The treatment of penetrating wounds of the inferior vena cava. Surgery 1962;51:195–204.

    PubMed  CAS  Google Scholar 

  99. Goldberger JH, Bernstein DM, Rodman GH, Suarez CA. Selection of patients with abdominal stab wounds for laparotomy. J Trauma 1982;22:476–80.

    PubMed  CAS  Google Scholar 

  100. du Trevou MD, van Dellen JR. Penetrating stab wounds to the brain: The timing of angiography in patients presenting with the weapon already removed. Neurosurgery 1992;31:905–11.

    PubMed  Google Scholar 

  101. Hodges C, Medberry C, Geehan D. Laceration of the external carotid artery after an intraoral stab wound. J Trauma: Injury, Infection and Critical Care 1998;45:644–6.

    CAS  Google Scholar 

  102. Mehanna HM, MacGregor FB. The case of the missing carotid artery — a well aimed knife! J Laryngol Otol 1998;112:387–8.

    PubMed  CAS  Google Scholar 

  103. Peacock WJ, Shrosbree RD, Key AG. A review of 450 stab wounds of the spinal cord. S Afr Med J 1977;51:961–4.

    PubMed  CAS  Google Scholar 

  104. Spitz WU, Petty CS, Fisher RS. Physical activity until collapse following fatal injury by firearms and sharp pointed weapons. J Forensic Sci 1961;6:290–300.

    Google Scholar 

  105. Karger B, Niemeyer J, Brinkmann B. Physical activity following fatal injury from sharp pointed weapons. Int J Leg Med 1999;112:188–91.

    CAS  Google Scholar 

  106. Perdekamp MG, Riede U-N, Pollak S. Penetrating stab wound of the heart with extraordinarily long survival time. Arch Kriminol 2000;206:102–9.

    PubMed  CAS  Google Scholar 

  107. Blatchford JW. Ludwig Rehn: The first successful cardiorrhaphy. Ann Thorac Surg 1985;39:492–5.

    PubMed  Google Scholar 

  108. Nathoo N, Nadvi SS. Traumatic intracranial aneurysms following penetrating stab wounds to the head: two unusual cases and review of the literature. Cent Afr J Med 1999;45:213–17.

    PubMed  CAS  Google Scholar 

  109. Cha EK, Mittal V, Allaben RD. Delayed sequelae of penetrating cardiac injury. Arch Surg 1993;128:836–41.

    PubMed  CAS  Google Scholar 

  110. Chukwuemeka A, Curry P, O’Riordan J. False aneurysm of the left ventricle after a stab wound to the chest. Ann R Coll Surg Engl 1999:81:94–6.

    PubMed  CAS  Google Scholar 

  111. Maitre B, Jouveshomme S, Isnard R, Riquet M, Pavie A, Derenne JP. Traumatic coronary-pulmonary artery fistula 23 years after a stab wound. Ann Thorac Surg 2000;70:1399–400.

    PubMed  CAS  Google Scholar 

  112. Kennedy RJ, Clements WDB, Mudd DG. A late complication from a self-inflicted stab wound. Ulster Med J 1999;68:40–2.

    PubMed  CAS  Google Scholar 

  113. Taupin JM. Testing conflicting scenarios — a role for simulation experiments in damage analysis of clothing. J Forensic Sci 1998;43:891–6.

    PubMed  CAS  Google Scholar 

  114. Scottish Trauma Audit Group. Preliminary analysis of the care of injured patients in five Scottish teaching hospitals: First report from the Scottish Trauma Audit Group (STAG). Health Bull (Edinb) 1995;53:55–65.

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag London Limited

About this chapter

Cite this chapter

Davison, A.M. (2004). The Incised Wound. In: Rutty, G.N. (eds) Essentials of Autopsy Practice. Springer, London. https://doi.org/10.1007/978-1-4471-0637-1_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-0637-1_8

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1168-9

  • Online ISBN: 978-1-4471-0637-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics