DIFFERENTIATION OF ANTEMORTEM & POSTMORTEM BURNS BY HISTOPATHOLOGICAL EXAMINATION
Keywords:
Burns, Histopathological examination, Junctional skinAbstract
Burns constitute a major cause of death and morbidity whatever reason may be, in the world and in this country too. Undoubtedly a severe burn is the most devastating injury a person can sustain and yet hope to survive. In the medico-legal setting, determination of whether the burns seen on a body are ante mortem or post-mortem in nature is of paramount importance. Whether the person was alive at the times of sustaining burns needs meticulous scrutiny as the person might have had died due to fatal burn injury or died due to some disease or sudden assault or injury and suffered burns later on. The differentiation between antemortem and postmortem burn is dependent upon the presence of vital reaction, as to be seen by histological examination. In the present study effort were made to differentiate antemortem and postmortem burns by histopathology of burnt and junctional skin. Blisters were present in 36% cases, pus was present in 54% cases, signs of healing were present in 26% cases and red line of demarcation was present in 88% cases. Histopathological findings of burnt and junctional skin showed separation of epidermis from dermis and breaking of epithelium in 90% cases respectively, vacuolisation and petechial haemorrages in 76% cases respectively; epithelial cells were flattened and elongated in 86% cases respectively. Capillary dilatation was present in 84% cases, odema and margination of leucocytes were present in 74% cases respectively, congestion and infiltration were present in 90% cases respectively. Skin was not available in 10% cases as the bodies were charred. Antemortem burns were present in 96% cases and postmortem burns in 4% cases. So histopathological examination plays a eminent role importance in differentiation of antemortem and postmortem burns.
References
Sawhney CP, Ahuja RB, Goel A. Burns in India : Epidemiology and Problems in Management. Indian Journal of Burns 1993; 1(1): 1.
Vij K. Thermal Deaths. Textbook of Forensic Medicine and Toxicology. 2nd Ed. B I Churchill Livingstone. New Delhi. 2002. p. 319-328.
Sevitt S. Histopathological changes in burned skin. Burns Pathology and Therapeutic Applications. Butterworth and Co. Ltd. 1957. p. 18-27.
Polson CJ, Gee DJ, Knight B. Burns. The Essentials of Forensic Medicine. 4th Ed. Oxford : Pergamaon Press. 1985. p. 141-142, 322-324.
Mukherjee J B. Thermal injuries.Injury and its medicolegal aspects. JB Mukherjee’s Forensic Medicine and Toxicology.Edited by R.N.Karmakar. 4th Edition.2011.Kolkata:Academic Publishers.467-468.
Cullings CFA, Allison RT, Barr WT. Staining and Mounting. Cellular Pathology Techniques. 4th Ed. London: Butterworths. 1985. p. 261.
Foley FD. Pathology of cutaneous burns. The Surgical Clinics of North America 1970; 50(6): 1201-1210. 8. Malik MOA. Enzyme Changes in the Early Phase of
Healing Skin Burns in Guinea Pigs. British Journal of Experimental Pathology 1971; 52: 345-352.
Cuppage FE, Leape LL, Tate A. Morphologic Changes in Rhesus Monkey Skin After Acute Burn. Archives Pathology 1973; 95: 402,405,440.
Mant AK Death from Physical and Chemical Injury, Starvation and Neglect. Taylor’s Principle and Practice of Medical Jurisprudence. 13th Ed. London : Churchill Livingstone. London. 1984. p. 251-253, 257-258.
Parikh CK. Thermal Injuries. Parikh’s Textbook of Medical Jurisprudence and Toxicology. 6th Ed. Bombay : CBS Publication. Bombay 2002. p.4.156.
Ritchie AC. Physical injury Boyd’s Textbook of Pathology. 9th Ed. Philadelphia London : Lea and Febiger. 1990. p. 567-568.
Emanuel R, John LF. Environmental and nutritional pathology. Company Philadelphia : JB Lipin Cott. 1988. p.303-304. South Zone Delhi. Punjab Medical Journal 1970; XX(12): 451.
Ganguli AC. Burns. Journal of Indian Medical Association1976; 67: 150-152.
Suarez-Penaranda J M, Munoz JI, de Abajo B Lpiez, Vieira DN, Rocho R et al. Concealed homicidal strangulation by burning. American Journal of Forensic Medicine and Pathology 1999; 20(2): 141- 144.
Narlawar UW, Meshram FA. Epidermiological determinants of burns and its outcome in Nagpur Journal of DMER 2002;19.