Estimating wound age: looking into the future

Abstract

A critical review is made of the studies on wound healing used for forensic purposes, focusing on the problem of which characteristics indicate that a parameter could be used as evidence in court. A panel analysing the more important information obtained by each marker is given, and a perspective of what might be expected from future research is discussed.

Analysis of Fibronectin and TGF-β1 Immunoexpression to Determination of Wound Vitality in Wistar Rats (Rattus norvegicus)

“…[1][2] Pemeriksaan luka adalah hal yang penting dalam kedokteran forensik sehingga penilaian vitalitas (apakah trauma terjadi semasa hidup) dan perkiraan usia luka merupakan permasalahan medikolegal yang penting dan mendasar. [2][3][4][5][6][7][8][9][10][11][12] Penilaian yang tepat dalam menentukan interval luka sangat membantu dalam penyelidikan kasus kriminal sehingga sangat penting membedakan luka antemortal dan luka posmortal. 9,12 Apabila diketahui bahwa luka atau trauma terjadi antemortal maka harus ditentukan pula waktu terjadinya luka sebelum kematian.…”

Vitality and wound-age estimation in forensic pathology: review and future prospects

“…Because it can also appear postmortem, however, it is not a reliable marker of wound vitality [1,14]. Therefore, morphological and molecular parameters should be used in combination to reduce the error when determining the time at which a wound was inflicted [6,24]. High-throughput analysis, whether at the mRNA or protein level, is a critical methodological advance.…”

“…with haematoxylin-eosin and Berlin blue staining) can detect changes 6 h after an injury [18][19][20], its practical application is limited. Immunohistochemistry and immunofluorescence studies, which are useful for estimating the age of early-stage wounds, allow (1) localization of tissue factors indicative of the stage of response and (2) determination of the phases of activation of individual cells [6]. These data enable evaluation of the linkage of morphology with function and close in on the interval of the wound age determined by assays of cytokines and adhesion molecules.…”

“…Infiltration by inflammatory cells is an indicator of tissue repair [1, 6,41,45]. Forensic pathologists, unlike general pathologists, tend to focus on chronologically mapping the appearance and disappearance of inflammatory cells or substances secreted during the inflammatory process.…”

“…Wound vitality can be evaluated using morphological, cytological, and molecular biological techniques. A number of biomarkers involved in vital reactions reportedly increase the accuracy of woundage estimation [6,7].…”