The morphology of cutaneous burn injuries and the type of heat application

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.forsciint.2009.03.002 Byline: T. Fracasso (a), H. Pfeiffer (a), P. Pellerin (b), B. Karger (a) Keywords: Burn injuries; Morphology; Burning agent; Forensic Abstract: The morphology of burn injuries in 120 consecutive patients from the Department of Plastic and Reconstructive Surgery, CHR, Hospital B in Lille was correlated to the etiology and type of heat. Analysis identified five typical patterns of cutaneous burn injuries. Jet of flame-pattern from methylated spirits and gasoline detonations: superficial burn injuries; sparing of skin wrinkles and the submental region; absence or small amounts of soot; preference of exposed body regions, esp. the face and hands. Explosion-pattern from explosions and electrothermal injuries: superficial burn injuries; sparing of skin wrinkles but not of the submental region; soot; preference of exposed body regions. Alveolar soot arrangement and metallisation in electrothermal injuries. Considerable third-degree burns in dust explosions. Flame-pattern from direct flame effects due to burning gasoline or oil, open fires or ignited clothing: nonuniform depth including large third-degree burns; no sparing of the submental region; soot; preference of body regions covered by clothing. Immersion-pattern: superficial (bullous) injuries; blurred junction between scalded and unscalded areas; extremities, buttocks, and back are favourite sites; cave child abuse: waterlines and zebra-burns. Spilling-pattern: superficial injuries; sharp junction between scalded and unscalded areas; head, anterior trunk, and upper extremities are favourite sites; running off and splashing stains. Consideration of these patterns can assist the reconstruction in fire investigations or unclear scaldings. In cases of suspected arson, a typical burn injury pattern or a single finding not compatible with the rest of the pattern can disprove a suspect or raise the level of suspicion. Author Affiliation: (a) Institute of Legal Medicine, University Hospital, Rontgenstr. 23, 48149 Munster, Germany (b) Department of Plastic and Reconstructive Surgery, CHR, Hospital B, 2 Av. Oscar Lambret, 59037 Lille Cedex, France Article History: Received 14 October 2008; Revised 5 February 2009; Accepted 2 March 2009