The Difficult Task of Interpreting Cut Marks, Gunshot Wounds and Ligature Marks on the Skin: A Cautionary Note

Research Article

Austin J Forensic Sci Criminol. 2016; 3(1): 1047.

The Difficult Task of Interpreting Cut Marks, Gunshot Wounds and Ligature Marks on the Skin: A Cautionary Note

Amadasi A, Cerutti E, Spagnoli L, Gibelli D*, Gorio C and Cattaneo C

Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy

*Corresponding author: Daniele Gibelli, LABANOF, Laboratorio di Antropologia e Odontologia Forense, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy

Received: June 07, 2016; Accepted: June 28, 2016; Published: June 30, 2016


The morphological assessment of skin injuries is a stronghold of forensic pathology and relies upon standard “rules” for a correct interpretation. But are these parameters reliable? When is the interpretation dangerously difficult? This study aims at quantifying the difficulties in the assessment of stab wounds, gunshot wounds and ligature marks by the observation of photographs in three questionnaires given to 11 experts (forensic pathologists) and 11 non-experts (trainees in forensic pathology). For stab wounds the overall percentage of correct answers was 47.5%, 56.9% for type of blade and 64.2% for type of edge. Gunshot wounds were correctly assessed only in 41.3% of cases. Finally, only in 47.1% of the cases a correct match ligature mark/object of constraint was found. The results show that wounds on the skin can frequently be misinterpreted if classification is strictly based on only morphological parameters; the judgment should therefore be based on an overall evaluation of all evidences, including also those provided by more advanced technological analyses (for example, SEM-EDS for the search of residues, radiological analyses, etc.).

Keywords: Forensic science; Forensic pathology; Stab wounds; Gunshots wounds; Ligature marks; Pictures; Skin


The morphological evaluation of wounds on the skin is one of the strongholds of every autopsy and of the common forensic practice: a correct interpretation of type of wound and of the type of weapon is of crucial importance and usually relies upon macroscopic features whose correct analysis is the basis for every further investigation.

As concerns stab wounds, many studies have been performed to find a relationship between sharp wounds and weapons, and some parameters have been identified as useful: size of the wound, depth, edges, the presence of additional features (notches, bruises, abrasions). However, it is quite evident that many variables can come into play: general features strongly depend on the characteristics of the knife (or other type of sharp weapon), and on body site, strength of the assailant, movements of assailant and victim [1-7]. Many authors consider morphological analyses on skin lesions reliable in the identification of the type of weapon, but the actual reliability in real case scenarios has never been practically tested and cases of atypical presentations and diagnostic difficulties have been frequently reported [8,9].

As concerns gunshot wounds, the distinction between entry and exit wounds and the identification of the range of the shot is crucial. The analysis of the shape, margins, presence or lack of additional elements (abrasion ring, stippling, searing, soot soiling) are the common basics of macroscopic assessment [10-13]; it is therefore evident how errors between entry and exit wounds can lead to misleading evaluations concerning the number of projectiles entering and exiting the body as well as the direction of the shot and the wound track. However, both entries and exits can show peculiar features and several cases of “diagnostic errors” and atypical presentations of gunshot wounds have been previously reported [14-16].

Finally, among blunt force injuries, ligature marks are characteristic and typical of asphyxial deaths but they can be found even in cases of victims of abuse and torture, when some sort of object of constraint is used. These marks usually arise from a combination of bruises and abrasions, as an expression of the mechanical effect on the skin’s surface [17-19]. The morphological analysis of the mark may be an important source of information for the identification of the object of constraint but ligature marks can be variable, depending on the nature of the ligature, strength and location on the body [20].

However, experience teaches that each and every autopsy and especially skin injuries may be misleading. As a matter of fact, several case reports have previously shown how difficult to interpret skin wounds can be, especially when “traditional” parameters (i.e. shape, dimensions, edges) are insufficient or even deceiving [8,9,14-16].

This led to the present study which aims at verifying how frequently such wounds can be misleading or misinterpreted by experts.

Thus, the study consisted in three questionnaires on stab wounds, gunshot wounds and ligature marks submitted to experts and non-experts, which aimed attesting the assessment of wounds on photographs of different types of injury on the skin.

Materials and Methods

A total of 66 questionnaires were submitted to 22 observers (13 females and 9 males) composed of 11 experts (forensic pathologists of 5-10 year experience) and 11 non-experts (trainees in forensic pathology, with at least one year of experience in the field). Assessments were performed on a total of 15 pictures for stab wounds, 15 pictures for gunshot wounds and 10 pictures for ligature marks.

pictures for gunshot wounds and 10 pictures for ligature marks. The results were then analyzed aiming at quantifying the difficulties of the observers in the morphological analysis and the differences among experts and non-experts. The details of every questionnaire are reported in the following paragraphs:

Stab wounds

Among the total 15 pictures, 4 were selected from real autopsy cases with known weapons (single and double-edged knives) and 11 were experimentally produced on pig skin with the wounding weapon kept perpendicular to the surface of the skin in order to simulate a stab wound. Two piglets, who had died of natural death, were used for the study: they were shaved to remove bristles and stabbed several times in different areas (abdomen, chest and thighs) with 9 different sharp weapons: 7 knives (5 single-edged knives, 3 with a smooth blade and 2 with a serrated blade and 2 double-edged knives, both with a smooth blade) and two different pairs of scissors.

In the related questionnaire (Figure 1) the observers were asked to state: