躯体创伤或瘢痕面积与长度折算关系的探讨

在法医实践中发现,现有的伤残鉴定标准中未就体表创口或瘢痕面积与长度测量的换算作出任何规定,对某些体表损伤的伤残评定可能有欠公允。有必要就此提出相应的解决办法,供同行探讨。     

体表创口与愈后瘢痕长度的法医学分析

皮肤、软组织损伤在法医学活体损伤程度鉴定或评定中较常见。在我国轻伤鉴定标准中，对面部创口、瘢痕的长度做了明确规定，头部、躯干、四肢等部位，只规定创口长度，未规定瘢痕的长度，给司法实践带来一定的困难。为此，我们对1995～2000年的400例伤者不同部位创口及愈合后的瘢痕进行测量，以此来探讨体表创口收缩情况与愈合后瘢痕长度的关系。1一般资料1.1性别、年龄状况400例伤者中，男342例（85.5%），女58例（14.5%），年龄最大55岁，最小者16岁，平均年龄35.5岁。1.2创口部位400例伤者中有的为一处创口，有的则为多处创口，其中头皮…     

对330例体表创口与愈后瘢痕长度的对比观察

探讨体表创口与愈后瘢痕相互关系。在 330例不同年龄的伤者的不同部位的钝、锐器伤口 ,用精确的测量方法 ,在伤后 3d内、伤后 1个月、伤后 3个月进行测量 ,并计算创口愈合成为瘢痕的收缩率。在伤后 3个月面部瘢痕的收缩率为 15 4% ,躯干、四肢瘢痕收缩率为 13 6 % ,头皮瘢痕收缩率为 10 1%。不同致伤物形成的创口 ,在伤后 3个月时 ,不规则钝器创的瘢痕收缩率为 16 1% ,锐器创的瘢痕收缩率为 11 2 %。结果表明 ,创口在伤后 3个月时 ,面部瘢痕收缩率最大 ,头皮瘢痕收缩率最小。不规则钝器创的瘢痕收缩率值比锐器创的瘢痕收缩率值大。     

创口和瘢痕损伤程度鉴定相关问题探讨

正1《人体损伤程度鉴定标准》中涉及"创口或者瘢痕"的条款《人体损伤程度鉴定标准》(以下简称《标准》)中有多条关于"创口或者瘢痕"的条款,但在学习和宣贯的过程中我们发现对于这些条款的理解还存在差异,在实际操作过程中也可能会出现争议。除了轻微伤之外,《标准》中有关"创口或者瘢痕"的条款共有12处(表1),分列于头面部(包括头皮、面部和耳郭)、颈前部、肢体和体表等不同条款中。     

三维测量技术在人体损伤程度鉴定的应用探讨

体表损伤程度的鉴定是法医临床鉴定工作的一项重要任务,为刑事案件、民事纠纷等提供科学依据。体表创口的长度、挫擦伤及瘢痕的面积是人体损伤程度鉴定等级划分的客观证据,而其精确测量是法医临床实际鉴定工作的难点。三维测量技术的出现为体表损伤程度的准确检验提供可能。本文着重对三维测量技术在体表损伤程度鉴定实践工作中的应用进行探讨,以期提高司法鉴定的准确性、科学性、公正性。     

三维测量技术在人体损伤程度鉴定的应用探讨CSCD

体表损伤程度的鉴定是法医临床鉴定工作的一项重要任务,为刑事案件、民事纠纷等提供科学依据。体表创口的长度、挫擦伤及瘢痕的面积是人体损伤程度鉴定等级划分的客观证据,而其精确测量是法医临床实际鉴定工作的难点。三维测量技术的出现为体表损伤程度的准确检验提供可能。本文着重对三维测量技术在体表损伤程度鉴定实践工作中的应用进行探讨,以期提高司法鉴定的准确性、科学性、公正性。     

根据衣服刺创口痕迹推断刺切顺序与刺器宽度

在法医检验鉴定中，常利用体表刺创口形态分析判断刺切的先后顺序与刺器宽度，但由于受人体皮肤组织状态、肌肉回缩和死后尸体腐败等因素影响，从而导致利用人体刺创口形态判断创口形成顺序与刺器宽度存在误差。而衣服上刺创口与体表上刺创口相对比，因其组织形态和腐败因素较之体表创口具有更稳定的特点，所以本研究依据衣服上刺创口痕迹来判断刺切顺序与刺器宽度。     

860例皮肤裂创伤口与瘢痕形成的关系分析

《人体重伤鉴定标准》和《人体轻伤鉴定标准》（试行）均对皮肤创口人瘢痕的长度（或面积）做了明确的规定。它对确定损伤程度起着决定性作用。但有较多的案例往往是在伤口愈合形成瘢痕后才进入到诉讼阶段。究竟摊痕与新鲜创口在长度上有何区别？其关系如何？对此，目前国内外法医界及医学界尚无定论，致使许多案件只能凭推测进行鉴定。笔者自1989年至1994年共收检、追踪调查皮肤裂伤案例860例。按照统计学原理，对新鲜皮肤创口与所形成的探痕之间的关系进行了探讨、分析。资料分析1．一般情况860例皮肤裂伤案例中，男623例，占72．44％；女…     

关于体表瘢痕法医学鉴定的几点思考

外伤致皮肤、软组织损伤在临床法医检案中极为常见,暴力损伤后创口或瘢痕长度与面积是评定损伤程度的重要依据.在《人体重伤鉴定标准》和《人体轻伤鉴定标准(试行)》中均有条款对皮肤创口的长度或疤痕做了相关的规定.但在实际检案工作中仍有一些问题值得思考,如是否根据皮肤瘢痕长度推算原创口长度;不同条款中规定的创口长度如何累计;手术扩创是否累计入原有创口.笔者结合多年实践经验就以上问题提出自己的见解,以便和同行商榷.     

肺内转移性霰弹异物的法医学分析1例

1案例资料某男，38岁。某日被他人用霰弹枪击中双大腿。医院查体见：双大腿前侧见散在分布较多细颗粒状的圆形创口，直径6mm左右，部分创口边缘沾有黑色污物。伤后3h的X线片（图1）示双大腿皮下浅、深层肌组织内见散在分布大量颗粒状的高密度金属异物阴影，胸部正位片（图2）示左肺下叶有二处颗粒状的金属异物影，右胸第8肋间隙于脊柱旁见二处颗粒状的金属异物阴影，第10肋间隙脊柱旁见一处颗粒状的金属异物影。胸腔内未见积液积气。伤后10h复查胸部X线片（图3），均示左肺下叶后侧仍见二处金属颗粒阴影，余胸、腹部未见颗粒状金属异物阴影。伤后1月进行临床法医学检查，双大腿前侧见大量密集的圆形、类圆形的新鲜瘢痕，最大者为0．8cm×0．6cm；余体表未见瘢痕。伤者否认案发前有霰弹枪受伤史。     

根据皮肤瘢痕长度推算创口长度法医学鉴定引发的思考

在肢体损伤程度鉴定中,经常会涉及瘢痕长度的问题。由于受伤当时条件的限制,往往不能在第一时间准确测量出创口的长度。在实际检案中,根据瘢痕长度鉴定损伤程度,若瘢痕的长度处于临界值时就很可能引起双方当事人的争议。本文通过一起实际案例,分析了出现争议的常见原因,以及在处理此类问题时应注意的相关问题。     

基于点云数据的瘢痕长度测量方案

瘢痕鉴定是法医工作中重要的一项任务,对瘢痕的纹理、位置和长度等信息都有着细致的规定和要求。通过三维扫描仪可以便捷地获取点云数据,还原瘢痕区域的具体结构,为瘢痕鉴定提供新的工具。本文基于三维点云数据,提取瘢痕的趋势线,进行瘢痕长度测量。该方案首先对三维瘢痕数据进行投影,在二维平面上提取瘢痕的端点和关键点。然后在三维曲面上通过近邻搜索和向量内积的方法,依次连接所有关键点得到沿瘢痕表面的趋势线,计算瘢痕的长度。本文实验中使用的三维瘢痕点云来自某法医司法鉴定中心的工作内容,通过三维扫描仪提取。在实验数据上的应用结果显示,提取的趋势线在瘢痕表面贴合程度较好,可以跟随曲面进行弯折,可靠性很高。以点为核心的计算方法,在后续测量功能改进中也有较大的空间。     

Streifenlichttopometrie (SLT): a new method for the three-dimensional photorealistic forensic documentation in colour

By means of the new method of Streifenlichttopometrie (SLT) it is possible to record the complete body surface of casualties in a practically photorealistic fashion, i.e. three-dimensionally and in colour. In comparison with the classic method of Photogrammetry Streifenlichttopometrie (SLT) is remarkably faster (10,000 points/s instead of 1 point/s) and in addition the colour of every point measured upon the corpse's surface is instantly recorded. Taking into consideration the resolution required and the qualities of the camera system the body surface is recorded in 'patches', i.e., areas of a defined extension (in the present case 500 mmx500 mmx200 mm) which are marked with a body fixed reference frame to grant the exact matching of the data after the recording process. Length, perimeter, square and volume of the body segments and injuries can be determined. Furthermore the natural colour of the wounds can be used for an immediate classification according to the intensity of the impact forces. In addition the 3-D coordinates of the body surface including the wounds can be transferred into an animated computer simulation for the reconstruction of the traumatic events.     

Concordance Rate for the Identification of Distant Entrance Gunshot Wounds of the Back by Experienced Forensic Pathologists Examining Only Images of Autopsies

The images of 66 gunshot entrance wounds with a defect on the back, a bullet in the body, hemorrhage along the wound track, and logical certainty that it was an entrance wound were collected from the files of a moderately busy medical examiner's office. Participants numbering 22 board‐certified forensic pathologists viewed a single digital archival image of each of the 66 entrance wounds randomly mixed with 74 presumptive exit wounds to determine whether they were entrance or exit wounds. The concordance rate for correctly identifying the 66 logically known entrance wounds was 82.8% with a range from 58% to 97%. This pilot study was conducted to provide an evidence‐based approach to the interpretation of the direction of gunshot wounds by reviewing pathologists with access only to archival photographs, and it is not a measure of the accuracy to distinguish entrance from exit wounds when given all of the circumstances.     

Site, number and depth of wounds of the scalp in falls and blows--a contribution to the validity of the so-called hat brim rule

The sites, numbers and lengths of wounds of the skin of the scalp and head caused by blunt injuries (falls from standing position, falls downstairs, blows) in an autopsy series. Analysis of the localization, length and number of wounds located at the head in 305 autopsy cases of falls from a standing position (203 cases), falls downstairs (51 cases) and blows with relatively long materials (51 cases). For the distinction between falls and blows, among several other aspects the so-called rule of the hat-brim-line is described: in cases of falls from a standing position down to a flat bottom, contusions can be expected in or near a line which represents the greatest horizontal circumference of the skull, whereas in cases of blows the contusions lay above this area. Although such a tendency was found in our material, a rule could not be confirmed: only approximately 55% of the wound due to blows were above this line, and in cases of falls from a standing position ca. 1/3 of the wounds were above this area. Only in the (dorso-frontal and parietal) region "top of the head" contusions due to falls from a standing position were quite uncommon. The mean length and length distribution of wounds in the hat-brim-zone was not different between the 3 causes of injuries; in positions above this, wounds due to blows were longer compared to those by falls. In falls from a standing position, only exceptionally more than 1 wound was found, whereas in cases of homicide several or many wounds were common. Single wounds due to blows were only found in cases, in which the victims were knocked down but not killed by blunt forces, and death was caused by other methods (e.g. strangulation or stabbing).     

Simulation of an attack by self-mutilating cuts and stab wounds

Self-inflicted cut or stab wounds may be used by the injured to make credible a feigned assault. In such cases the alleged traces of the crime are found on the body and the clothing of the informant. Occasionally the very pattern of the injuries points to self-infliction. For example the following findings may be indicative of self-infliction: a greater number of very superficial wounds, wounds parallel or grouped, mostly located on the left side of the body (in right-handers) or symmetry in arrangement, intact clothing or lack of correspondence between wounds and damage of clothing, absence of typical defence and protection injuries. In the light of 4 cases observed from the material at hand, special features of the lesion appearance are shown and possible motives for the deed discussed.     

Characteristics of Bone Injuries Resulting from Knife Wounds Incised with Different Forces

The aim of this research was to experimentally determine the characteristics of incised bone wounds, which are commonly found in defense injuries. A specially constructed pivoting arm device was used to inflict wounds with controlled forces and direction. Five knives were selected to inflict the wounds on porcine forelimbs. Eight incised wounds were made per knife per force. A larger knife and a greater force caused longer and wider bone wounds. Comparisons of individual knives at the two forces produced varying results in the bone wounds. A correlation was seen between the force and the length (r = 0.69), width (r = 0.63), and depth (r = 0.57) of bone wounds. Serrated‐edge and nonserrated knives can be distinguished from the appearance of the wound. The outcomes may be applicable in forensic investigations to ascertain the forces associated with incised wounds and identify the specific knife used.