Lacerations are caused by blunt force splitting the full thickness of the skin (see Fig. 6) most frequently when the skin and soft tissues are crushed between impacting force and underlying bone. Boxers classically develop lacerations when a boxing glove presses on the orbital rim. As with abrasions, the injury site is indicative of the impact site. Lacerations can bleed profusely, particularly on face and scalp. When inflicted deliberately, the force may cause the assailant and weapon to be contaminated with blood.
Lacerations have characteristic features but often mimic incised wounds (or vice-versa), particularly where the skin is closely applied to underlying bone, for example, the scalp. Close examination of the margins of the wound, which are usually slightly inverted, normally resolves the issue. Lacerations are ragged wounds caused by crushing and tearing of the skin. They tend to gape open, and their margins are often bruised and abraded. Blood vessels, nerves, and delicate tissue bridges may be exposed in the depth of the wound, which may be soiled by grit, paint fragments, or glass.
The shape of the laceration may give some indication regarding to the agent responsible. For example, blows to the scalp with the circular head of a hammer or the spherical knob of a poker tend to cause crescent-shaped lacerations. A weapon with a square or rectangular face, such as the butt of an axe, may cause a laceration with a Y-shaped split at its corners.
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