DEFINITION
Bruise or contusion may be defined as extravasation of blood in the subcutaneous or submucous or subserous tissue or space due to rupture of blood vessels (commonly capillaries or venules) by application of brutal blunt force, without the breach of continuity of the skin or overlying tissue.
FEATURES OF BRUSE
- When fresh, reddish.
- Slightly raised above the surrounding area.
- Painful and tender.
- It may have denudation of the covering cuticle.
- Gradually changes its color.
- It may take the form of the striking part of the weapon.
- It may appear visible several moments after injury.
- May appear away from the site of the injury.
FACTORS INFLUENCING BRUSE
- Age
- Sex, Race, Complexion
- Quantity of the force applied
- Quality of the force applied
- Site of application of the force
- Blood supply in the area
- Laxity of the tissue
- The surface area of the striking part of the weapon
- Pathological conditions-
- ITP
- Hemophilia
- Scurvy
- Leukemia
- Vit-K deficiency
- Prothrombin
MEDICOLEGAL IMPORTANCE OF BRUSE
- Patterned bruises may connect the victim and the weapon
- The age of the injury may be determined by its color change
- The degree of violence may be determined by its size
- For example, the character and manner of injury of an abrasion may be known by its distribution.
- The time of assault can be ascertained
- Bruise may simulate hypostasis, congestion, blood dyscrasias, etc.
- False bruises may be produced by various irritant substances to bring false charges of assault against somebody.
WHY BRUISES ARE LESS IMPORTANT THAN ABRASIONS BECAUSE-
- Their size may not correspond to the size of the weapon.
- They may become visible several hours or even 1 to 2 days after injury.
- They may appear away from the actual site of impaction.
- They are not able to indicate the direction of forces.
- Their size, shape, and color depend upon many factors.
HOW AGE OF THE BRUISE IS DETERMINE–
The age of the bruise can be determined by its color changing with time. Although the changing is variable, it starts from the periphery and extends towards the center. The changes are as follows-
At fresh Red
Few hours to 03 days: Blue (due to carboxyhemoglobin)
On the 4th day: Bluish black to brown (due to haemosiderin)
05 to 06 days: Greenish (due to haematoid)
07 to 12 days: Yellow (due to bilirubin)
At about 15days: Normal
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