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A 59-year-old man was found dead in his living room. His body was covered with blood, but the only injury found was a 31-mm-long, transverse incision on the radial surface of the left forearm. Autopsy revealed that the injured vessel was an enlarged cephalic vein from a radiocephalic arteriovenous fistula (RC-AVF) that had been created 23 years before for hemodialysis. Cephalic vein injury is usually not fatal, but circumstantial evidence, autopsy, and histological findings suggested that hemorrhagic shock and death occurred within a short time after the self-inflicted incised wound. This may be explained by the blood flow rate in the RC-AVF, which can reach 12 ml/s; this is 25 times higher than the normal cephalic vein blood flow.

Objective: This study was undertaken to compare the curative efficacy of marigold leaf paste and turmeric paste on healing the incised wound in sheep. The study also determined the anti¬microbial effects and histopathological changes in a wounds healing process treated with these medicinal herbs. Materials and Methods: Surgical wounds (n = 18) were created aseptically in the skin of the flank region of six healthy sheep dividing them into three experimental groups. Follow-up data were taken up to day 21. Different morphological characteristics of the wound and wound contraction (length and width) were recorded weekly. Samples were collected on days 1, 2, and 3 to test the antimicrobial effects and on days 1, 3, and 7 for histopathological studies. Results: Treatment with marigold leaf paste and turmeric paste resulted in a swelled wound area of 11.78 ± 0.38 mm and 11.52 ± 0.27 mm, respectively. The wound areas were comparatively lower than that of the control group (11.44 ± 0.20 mm). Moreover, the least elevation (2.44 ± 0.12 mm) of the sutured line from the skin surface was noted and compared between the marigold leaf paste and normal saline (2.74 ± 0.13 mm). Bacterial colonies in the nutrient agar medium cultured with swabs from the normal saline-treated groups wound area were found on day 1. On the con¬trary, bacterial colonies were absent on days 2 and 3 of treatment in the groups treated with both the paste of marigold leaves and turmeric. Less intense tissue reactions and higher keratinization of epithelium were shown in the group treated with marigold leaf paste than turmeric paste and saline-treated groups. Conclusion: Marigold leaf paste showed less tissue reaction and healed the wounds effectively. Thus, this paste could be used for the treatment of superficial wounds in sheep. [J Adv Vet Anim Res 2020; 7(4.000): 750-757]

Aim: This research aimed to evaluate the effects of pomegranate extract standardized to 40% ellagic acid on the incised wound in albino rats. Materials and Methods: Fifty albino rats were divided into 10 treatment groups. The five groups were sacrificed on the 8th day, while the others were sacrificed on the 15th day. Two groups of albino rats with incised wound were not treated at all (P0), the other two groups of albino rats with incised wound were treated with Betadine® (P1) ointment, and the rest of the groups were treated with pomegranate extract standardized to 40% ellagic acid with a concentration of 2.5% (P2), 5% (P3), and 7.5% (P4). The treatments were carried out twice a day with an interval of 12 h for 7 and 14 days. At the end of the research, the skin tissue of those albino rats had been taken for histopathologic preparations before H and E staining was performed. Results: Collagen deposition, polymorphonuclear neutrophils (PMN) infiltration, angiogenesis, and fibrosis degree in Group P4 treated with 7.5% pomegranate extract standardized to 40% ellagic acid for 14 days were significantly different from those in Groups P0, P1, P2, and P3, especially in the case of PMN inflammation (p

The composition of phenolic constituents from common mallow leaves was studied by HPLC. Total flavonoids and hydroxycinnamic acids were determined quantitatively as 2.97 ± 0.08% and 2.84 ± 0.03%, respectively. Luteolin (96.12 mg/100 g) and chlorogenic acid (51.04 mg/100 g) dominated the extracted phenolic compounds. Pharmacological tests (acute exudative inflammation model, wound-tensiometry on linear incised wound model, Nesterov test) were conducted. It was established that a gel with mallow extract applied to animals with inflammatory pathologies decreased statistically significantly as compared with a control the inflammation index and exudation rate. The complex of phenolic compounds may have been responsible for this. Reparative, capillary-protective, and hydrating effects of the plant extract were also found. The obtained results provided experimental justification for treating inflammatory pathologies with mallow leaves and using this plant to treat dermatological diseases. The prerequisites for developing dosage forms from common mallow extract and introducing it into official medicine have been created.

Injury is a serious public health threat as it is one of the leading cause of death globally. This study aims to assess the prevalence of injury, pattern of injury and its associated factors among people residing in a rural area of Aurabani VDC of Eastern Nepal. A population based cross sectional study was carried out among 552 people residing in selected wards with door to door visit. The prevalence of minor injury was 3.1% and major was 0.4% per year in the study.Most common mode of injury was fall and most common type was incised wound. Injuries mostly occurred in extremities, in morning time, autumn season and in roads while most of the injuries were accidental in nature.

An adult male Australian sea lion (Neophoca cinerea) presented with a deep, almost circumferential, incised wound around the neck caused by a noose formed by a single strand of green nylon rope. The wound extended 4-5 cm deeply through the skin and blubber into skeletal muscle, predominantly on the dorsal surface and left side, but had not involved the airway or major vessels. The edges of the wound were sharply incised and oozing blood with a granulating infected base. The rope was removed and the wound debrided of necrotic tissues and irrigated with disinfectant. Antibiotic and rehydration therapy were successful and the seal was released after 2 weeks of treatment. Entanglement injuries such as “neck collars” have characteristic features, are increasing in incidence and often have lethal outcomes. This type of injury may significantly impact upon populations of pinnipeds in the wild.

Precise assessment of wound healing degree is important to avoid infection and achieve good prognosis without remaining of keloid or hypertrophic scars. In this paper, we apply the combination of second-harmonic-generation (SHG) microscopy with third-harmonic-generation (THG) microscopy for incised wound animal model, and visualize collagen dynamics during the wound healing process in time series in situ. Due to the difference of contrast mechanism, SHG image visualizes distribution of dermal collagen fibers whereas THG image visualizes surface of the epidermis. SHG/THG microscopy enable us to track the phase of wound healing for the same subject from the viewpoint of the temporal and spatial dynamic of collagen fibers and the epidermis surface.

The purpose of this study was to examine the actual state of injuries experience and safety accident prevention in dental hygienists. This study surveyed the actual state of injuries experience caused by apparatus and materials through a self-administered survey of 366 dental hygienists. Statistical analysis was performed using PASW Statistics 18.0. Frequency, chi-square test, t-test, one-way ANOVA were applied in this analysis. The results were as follows: Out of the 307 subjects (83.9%) experienced injuries in the last 6 months, and 294 subjects (80.3%) chose the stab as the most frequent type of injuries experience and it was followed by incised wound, scratch and burn. In relation to the differences in injuries experience depending on general characteristics, there were significant differences depending on the age, career, position, dental treatment (p< 0.001) and the education (p

A planned complex suicide is the complex action mechanism, formerly planned to protect the victim of suicide from failure. A 22-year old undergraduate student was found dead at his home in the toilet with a cut injury to the left wrist. Autopsy findings revealed an incised wound at the left wrist along with signs of corrosive acid poisoning. Death scene investigation confirmed it as a case of planned complex suicide. To the best of our knowledge combination of methods used in this case is unique and has not been reported previously. The sequence of events in this case was difficult to determine as both the methods used viz. cut wrist and corrosive acid poisoning were sufficient to cause death individually. Also the duration between the events must have been so less that the sequence of events was difficult to be determined.

This chapter focuses on cranial and post-cranial injuries produced from sharp forces. In all, 30 cases of homicidal, suicidal, and accidental sharp-force trauma from a range of implements are presented. In addition to cases of stab injuries, examples of dismemberment are also presented. Objects causing the skeletal trauma include a flat-head screwdriver, knives (single-edged, serrated, curved, kitchen, and hunting), scissors, a samurai sword, hacksaw, hatchet, electric power saw, nail, angle grinder, and a lathe.

Background : Rana Plaza collapse is the worst and deadliest man-made industrial disaster in the history of garment sector in the world. Around 1200 people died and thousands more were injured. Most of the victims of the disaster were treated in Enam Medical College Hospital (EMCH). We conducted this study to give an overview on the disaster victims and services provided by EMCH. Objective : The study was done to observe the length of time between accident and admission in EMCH, length of time between admission and discharge, to observe the numbers, types and sites of injuries to the victims, medical measures given to the victims and finally to observe the status of the victims at the time of discharge. Materials and Methods : This descriptive type of observational study was carried out among the victims of Rana Plaza tragedy during the period of May to October 2013. All admitted patients in EMCH were included in the study. Purposive nonprobability sampling technique was applied in this research work. Data were collected from the hospital record. After collection, data were manually compiled, edited and analyzed. Results : Among 621 victims treated in different wards, 276 (44.45%) were admitted to the hospital on the day of accident. Among the admitted patients, 255 (41.06%) stayed in the hospital for 1--3 days,133 (21.42%) for 4--7 days and 88 (14.17%) for more than 10 days. Fracture and dislocation were present in 32.70% patients, lacerated injury in 18.20%, abrasion in 15.78%, bruise in 13.53%, incised wound in 15.45% and punctured wound in 4.34% patients. Single injury was present in 56.68% and rest had multiple injuries. Lower limbs were the most (33.01%) affected part of the body followed by head and neck (22.06%), upper limbs (18.52%), thorax (17.55%) and abdomen (8.86%). Two hundred seventy two patients (43.80%) were improved after treatment and 56 (9.02%) were fully cured; 23.83% of the victims were referred to higher medical centers for special measures. Conclusion : The collapse of Rana Plaza has fueled a greater call for reform and safety in garment industry. At the same time, all health care centers should adopt a broad-based approach to disaster-preparedness by providing a framework to ensure a well-coordinated response to mass casualty event. DOI: http://dx.doi.org/10.3329/jemc.v4i1.18066 J Enam Med Col 2014; 4(1): 31-35

Legal term hurt means bodily pain, injury or wound and disease or infirmity caused to any person. Abrasion, bruise, laceration, fracture, dislocation, incised wound, stab wound, puncture, penetrating wound, firearm wound, bomb blast wound, burn, scald are common types of injury or hurt. Different types of weapons or means used to cause hurts are blunt, sharp and pointed weapons, firearms, bombs, heat, electricity and corrosives. For legal purposes, hurts are grouped as grievous hurt and simple hurt. There are eight categories of grievous hurt. In reporting hurt cases, the clinical state of the victim with full description of the wounds are noted and an opinion regarding their legal state i.e. whether grievous or simple, age of the injury, type of the weapon or means causing the injury, whether inflicted by others or self inflicted etc. is given. These help the court to give its judgment. There are enacted laws describing section, numbers, types of crime and their punishments. Anwer Khan Modern Medical College Journal Vol. 4, No. 2: July 2013, Pages 37-41 DOI: http://dx.doi.org/10.3329/akmmcj.v4i2.16941

Introduction: Distal median nerve masses may be developed post-traumatic or non-traumatic. In this paper, we aim to present a 52 year old female case with a postraumatic neuroma of the median nerve in the left wrist. Case Report: A 52-year-old female patient had accidental incised wound over her left wrist which was primarily sutured. She presented 6 months later with unrelieved pain and growing swelling at the wrist. USG showed solid mass of size 2×3 cms. Intraoperatively the mass was seen to arise from medial nerve and careful excision was done protecting the nerve. At one year follow up the patient is relived of her symptoms with no sensorimotor deficit. Conclusion: Post traumatic neuroma present as unrelieved pain and progressive swelling. A high index of suspicion should be kept in cases of wound that are primarily sutured over an area with superficial nerves. Careful excision of the lesion is very effective in relieving patients symptoms Keywords: Neuroma, wrist, median nerve, nerve ınjury.

Background In a previous study, we proposed a new therapy using topical bromelain as a supplement to simple wound-track incision for the debridement of firearm wounds. This enzymatic debridement greatly simplified the management of high-velocity gunshot wounds in a pig model, and bromelain was confirmed to improve wound healing. The purpose of the present study was to investigate the effect of bromelain on the microenvironment of firearm wounds. Methods Sixteen Chinese landrace pigs wounded by high-velocity projectiles were divided randomly into four groups: wound incision (group I), incision + bromelain (group IB), wound excision (group E), and control. Blood perfusion, oxygen partial pressure (pO2), and the content of tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β in wound-track tissue were measured. Wound healing was also noted. Results The recovery of blood perfusion in tissue and pO2 in wound tracks was significantly more rapid in group IB and group E than in group I and control. The tissue level of TNF-α was significantly lower in group IB than in group I and control 48 h and 72 h post-wounding, and was lower than in group E 48 h post-wounding. The tissue level of TGF-β in group IB was sustained at a significantly higher level than in the other three groups. Wound healing time was also shorter in group IB. Conclusions Enzymatic debridement using topical bromelain in incised wound tracks accelerates the recovery of blood perfusion, pO2 in wound tissue, controls the expression of TNF-α and raises the expression of TGF-β.

SOLUTION The running butterfly suture is a novel approach to closing wounds under minimal tension. The technique is performed as follows: with the wound oriented parallel to the surgeon’s body, the needle is inserted through the outside of the wound, lateral to the apex, exiting in the interior of the wound. Alternately, a buried anchoring suture, such as a simple buried suture, buried vertical mattress suture, or set-back dermal suture, may first be placed. The far wound edge is then gently reflected back with the forceps, as the needle enters at the junction where the base of the incised wound edge meets the undersurface of the dermis (Fig 1). The needle then proceeds on a diagonal course, angling upward toward the surface of the skin and outward away from the wound edge, before exiting again at the base of the undermined wound edge, further along the length of the wound than its entry point (Fig 2). The needle is then reloaded, and the procedure is repeated on the contralateral wound edge. As when using the standard running subcuticular technique, the entry point on the contralateral wound edge should be slightly backtracked from the exit point on the prior side to reduce the risk of tissue bunching. Alternating bites on each side of the wound are taken until the end of the wound is reached, at which time either a final anchoring suture may be placed or the suture material can exit lateral to the apex and be secured, leaving a well-everted wound (Fig 3).

The examination of the body of a murdered adult female found in her apartment revealed the presence of a 6-inch screwdriver in the skull cavity that had been inserted through the medial border of the left eye. The presence of a small bruise around the medial aspect of the eye together with the absence of fresh hemorrhage along the tract of the screwdriver was consistent with a postmortem origin. Death, however, was caused by a large incised wound of the neck and multiple skull fractures consistent with hammer blows.

A 29-year-old sheep shearer collapsed after walking across a shearing shed floor, holding his hand over an incised wound to his neck. Attempted resuscitation was unsuccessful. At the death scene fine arterial blood spatter was noted and at autopsy a single incised wound to the neck was observed, the patterned edges of which corresponded to the teeth of the shears. Dissection revealed injury to the underlying jugular vein and the mid portion of the common carotid artery. Death was attributed to blood loss from an incised wound of the left side of the neck. This case demonstrates the rare event of an accidental death related to the actions of a sheep. Although a relatively small animal, review of the circumstances and interviews with those present revealed that sudden and unexpected movement of the sheep during shearing had caused the shearer to lose control of his electrical shears resulting in a lethal incised wound to the neck. The blood spatter pattern at the scene was supportive of both witness descriptions and the findings at autopsy.

症例は74歳,男性.鉄道沿線の草刈り作業中,他の人の自動草刈り機の刈刃が背部に接触し外傷を負ったため,救急車で当院に搬送された.創は長さ25cmにわたり筋肉,肋骨が切断され胸腔内に到達しており創から左肺が観察された.ただちに全身麻酔下に手術を行い胸腔内の観察を行ったところ,心・大血管の損傷はなかったが,左肺下葉(S6)に幅8 cm,深さ2 cmの損傷を認めた.自動縫合器を用いて同部を切除・縫合し,胸腔内および胸壁創を充分洗浄したのち閉胸,手術を終了した.経過は良好で術後10日で退院した.

On March 3, 2009, the remains of an adult male were partially buried at the Southeast Texas Applied Forensic Science (STAFS) Facility at the Center for Biological Field Studies (CBFS), Sam Houston State University, Texas. The individual was buried except for a small portion of the left abdominal region. A postmortem incised wound was created in the exposed area with the intention of attracting carrion flies. Worker ants of a colony of Solenopsis invicta Buren 1972 (red imported fire ant) filled in the wound with soil, thereby monopolizing the exposed area of the corpse and excluding expected carrion insects from the wound. During the bloating phase, approximately nine days after burial, normal decomposition processes of the gut created a sufficient disruption of the ants, such that flies oviposited and larvae were able to colonize the corpse. Estimation of the postmortem interval (PMI) based on the minimum period of fly activity would be severely skewed should the remains be discovered at this point and growth rate of Diptera larvae be used as the primary determinant for the PMI. While S. invicta is an expected member of a carrion ecosystem in southeastern Texas, and is known to distort the PMI estimation through larval and egg removal, the complete exclusion of flies from the wound by the burial behavior of S. invicta was an unexpected and until now an unpublished occurrence.

Genistein, the most abundant isoflavone in soya, is an inhibitor of tyrosine kinase, angiogenesis, and topoisomerase II. In Korean folk medicine, ancestors applied the soybean paste on the lacerated or abraded skin wounds, which they believed made faster wound healing with less scar. However, there is yet no precise quantitative study on the effect of genistein or soybean paste on wound healing. This study is aimed at the potential effect of genistein on soft tissue wound healing in rat model.Forty 200300 gm Long-Evans Rats were used. They were divided into 4 groups and sub-grouped into 1 wk and 2 wk follow-up groups. Five rats were used for each subgroup. After closing of an incised wound, either carrier or genistein was applied in Group I. In Group II, 0.5 ml Aquaphore was applied daily to the wound. In Group III, 0.5 ml Aquaphore containing 1 mg genistein and in Group IV, 0.5 ml Aquaphore containing 4 mg genistein were applied daily.The wounds of Group I and Group II were wider than the ones of...

Columellar and nostril shapes often present irregularity after transcolumellar incision for open rhinoplasty, because of the contracture of the incised wound. The present study introduces a new technique to prevent this complication, and verifies its efficacy in improving cosmetic appearance. In our new method, a zig-zag incision with three small triangular flaps is made on the columella and in the pericolumellar regions of the bilateral nostril rims. Since the shape of the incision resembles the contour of an inverted "batman", we term our new method the "Inverted Batman" incision. To verify the effectiveness of the Inverted Batman incision, aesthetic evaluation was conducted for 21 patients operated on using the conventional transcolumellar incision (Conventional Group) and 19 patients operated on using the Inverted Batman incision (Inverted Batman Group). The evaluation was performed by three plastic surgeons, using a four-grade scale to assess three separate items: symmetry of bilateral soft triangles, symmetry of bilateral margins of the columella, and evenness of the columellar surface. The scores of the two groups for these three items were compared using a non-parametric test (Mann-Whitney U-test). With all three items, the Inverted Batman group patients present higher scores than Conventional Group patients. The Inverted Batman incision is effective in preserving the correct anatomical structure of the columella, soft triangle, and nostril rims. Hence, we recommend the Inverted Batman incision as a useful technique for open rhinoplasty.

Sharp-force injuries are traditionally divided into stab, cut, and chop wounds. Stab wounds occur when a pointed object—usually a knife—penetrates into the body along its longitudinal axis. Cuts are caused by the slicing effect of a blade, and chop wounds are produced by blows with a sharp-edged tool such as an axe or a machete. A morphological feature common to all wounds caused by sharp force is that the skin lesions have smooth, uncontused, more or less gaping margins. Fatal outcomes are mostly due to strong internal and/or external bleeding. Medicolegal investigations are performed for documentation of the injuries and interpretation as to how they came about and whether they were inflicted by the victims themselves or by another person. The group of self-inflicted injuries includes completed and attempted suicides, dermal artifacts in patients with personality disorders, voluntary self-damage among prisoners, those inflicted for the purpose of insurance fraud, and, finally, those for simulations of criminal offenses. Characteristic findings help the forensic expert to differentiate between accident, suicide, and homicide. The presence of defense injuries is a certain indicator for an attack with a sharp instrument. The article gives a short overview of the circumstances, phenomena, and consequences of sharp-force injuries. The text is illustrated by numerous photographs from forensic routine work. Keywords: sharp force; stab wound; cut; incised wound; chop wound; defense injury; knife attack; suicide; homicide; accident; self-inflicted injury