65
Volume 04 Issue 03-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
03
Pages:
65-69
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
ABSTRACT
In the modern world there is a constant increase in the number of fires in residential and industrial premises, transport,
which leads to injuries and often fatalities [4,15]. According to data of the summary reports on activity of territorial
bureaus of forensic-medical examination of the Russian Federation at fires from thermal traumas and carbon
monoxide poisoning 15 918 persons were lost in 2000 and 16 416 - in 2008. It makes about 3 % from all forensic medical
autopsies [5]. A similar situation is typical for the Republic of Tajikistan [11].
By now, the causes, pathogenesis, pathomorphosis [6, 12], clinical and morphological features [1, 10], epidemiology
of thermal injuries [5], combined effects of thermal and carbon monoxide [7, 9], injuries caused by mechanical effects
of falling parts of a burning building and various objects [14] have been studied in sufficient detail.
KEYWORDS
Burn injuries, mechanical impact, thermal injuries.
Research Article
THE FORENSIC SIGNIFICANCE OF THE BURN INJURY CRITERIA
Submission Date:
February 28, 2022,
Accepted Date:
March 20, 2022,
Published Date:
March 31, 2022 |
Crossref doi:
https://doi.org/10.37547/TAJMSPR/Volume04Issue03-13
Makhmudjonova Sitorabonu Rustamovna
A student in group 309 of the Faculty of Medical Pedagogy Samarkand State Medical Institute, Uzbekistan
Shavkat Eryigitovich Islamov
Associate Professor, Doctor of Medical Sciences, Department of Forensic Medicine and Pathological
Anatomy Samarkand State Medical Institute, Uzbekistan
Makhmatmuradova Nargiza Negmatullaevna
Assistant to the Department of Internal Medicine No. 4. Samarkand State Medical Institute, Uzbekistan
Journal
Website:
https://theamericanjou
rnals.com/index.php/ta
jmspr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
66
Volume 04 Issue 03-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
03
Pages:
65-69
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
INTRODUCTION
In recent years, there has been an increase in the
incidence of burn injuries caused by flammable liquids
on the human div, but there has been little research
in this area [8]. Thermal trauma injuries and resulting
diagnostic and treatment failures often lead to death
or disability [2,13].
Due to the great importance of the problem of fatal
thermal trauma, there is a need to develop
morphological criteria for assessing injuries, a
methodology
for
determining
whether
the
circumstances and conditions of trauma are consistent
with the results of forensic examination of a corpse
[11].
According to other researchers, the number of
cadavers with lethal thermal trauma over 5 years (from
2003 to 2007) against the total number of examined
corpses was 5.73%; the number of expert examinations
performed to determine damage to health caused by
exposure to extreme temperatures in living persons
averaged about 0.6% of the total number of
examinations performed [3].
It should be noted that thermal trauma requires a
special scientific and methodological approach in
determining the severity of harm to health, as it is not
an uncommon type of forensic medical examination.
The aim of the study was to identify forensic criteria for
burn injury.
MATERIALS AND METHODS OF RESEARCH
Our researches are executed on the practical forensic-
medical material. All of them are the results of the
forensic medical examinations carried out in the
Samarkand Regional Branch of the Republican
Scientific and Practical Center of Forensic Medicine. In
the course of the study the analysis of acts of forensic
medical examination of living persons and experts'
conclusions, as well as the examination of living
persons were carried out. The material used is mostly
own observation, and was conducted jointly with other
experts. Macroscopic examination was performed
using traditional methods. A study of patients who
were inpatients at the Combustology Department of
the Samarkand Regional Branch of the Republican
Scientific and Practical Centre for Emergency Medicine
was also carried out by examining case histories. Of
the total number of persons examined for thermal
trauma -60 cases, of which 21 were examined in the
forensic-ambulatory department (group I) and the rest
in the combustology department (group II). There
were 19 females and 41 males aged 6 to 69 years.
Non-fatal thermal trauma was observed in all
investigated cases. In this type of trauma, there was a
predominance of injuries to the head, neck, chest,
upper and lower extremities. All persons were
examined in the forensic and ambulatory department
more than 1 day after the injury, some of them after in-
patient treatment. The examination was carried out in
the combustology department at different periods of
in-patient treatment.
According to anamnestic data, all those examined prior
to the trauma were considered to be healthy and able
to work. Diseases that were found in living persons
were noted in patients who had been inpatients at the
Department of Combustology of the Samarkand
Regional Branch of the Republican Scientific and
Practical Centre for Emergency Medicine.
67
Volume 04 Issue 03-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
I
SSUE
03
Pages:
65-69
SJIF
I
MPACT
FACTOR
(2020:
5.
286
)
(2021:
5.
64
)
(2022:
6.
319
)
OCLC
–
1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
STUDY RESULTS
Among all thermal trauma cases, 32 cases from flames
(53.3%) and 13 cases from ignition of flammable liquids
(25.0%) were observed. There were also electrical
burns in 6 (10.0%) and contact burns in 4 (6.7%). In 6 of
the observations, the flammable liquid ignition injuries
occurred at work, in 4 observations (13.95%), road
traffic accidents involving exposure to flammable
liquids (petrol) and in 5 cases at home. Injured by
thermal trauma in the first group lived in rural areas in
12 cases (63.8%) and in urban areas in 9 cases (36.2%).
In 41 observations (66.5%), the div showed a peculiar
ring shape of burns with petals oriented parallel or
perpendicular to the length of the div. The burns
often covered an area of 25 to 80% of the div surface.
In a small proportion (3) of the inpatient cases, there
was a combination of thermal trauma and mechanical
injuries that could not have been self-inflicted. In such
circumstances, a separate evaluation of the severity of
the injuries was carried out.
The study revealed that the number of patients with a
total burn area was distributed as follows: 20-29% - 10
(16,7%), 30-39% - 8 (13,3%), 40-49% - 11 (18,3%), 50-59% - 13
(21,7%), 60-69% - 9 (15,0%). The area of deep burns was
in the following order: 10-19% - 12 (20,0%), 20-29% - 10
(16,7%), 30-39% - 16 (26,7%), 40-49% - 9 (15,0%), 50-59% - 8
(13,3%).
In identifying features, it was noted that in Group I, the
total area of burns in 5 cases (23.8%) was up to 10%, in 6
cases 31-40% (28.6%). It should also be noted that in 5
cases (23.8%) the area of the burn was not indicated in
the report.
Group I examinees were distributed according to the
degree of burns as follows: Grade I burns were
observed in 2 persons (9.5%), Grade I-II and III, III AB in
4 (19.0%) each. II-III and II-III degree by 3 (14.3%).
We analyzed the hospitalization of Group I patients as
follows: up to 10 days - 9 patients (42,9%), 11-20 days - 5
(23,8%), 21-30 days - 1 (4,8%), over 30 days - 2 (9,5%), 4
(19,0%) did not apply for medical help.An analysis of the
structure of burns localization revealed the following
features. Thus in Group I examinees they were
distributed in the following order: head, neck (19.0%),
trunk, extremities (19.0%), upper extremities (19.0%),
lower extremities (14.3%). And in group II patients who
were hospitalized, the distribution was as follows:
trunk, extremities (30.8%), head, extremities (28.2%),
trunk (15.4%), lower extremities (12.8%).In a direct
analysis of the localization of injuries separately by area
in Group I, they were distributed in the following order
: Head (15.6%), neck (10.0%), upper extremities -
shoulder (11.1%), elbow (14.4%), hand - (10.0%), trunk -
chest (10.0%), abdominal region (5.6%), lower
extremities - hip (10.0%), shin (8.9%), foot (2.2%), gluteal
region (2.2%).
When examining Group I individuals, the presence or
development of comorbidities and their complications
was denied. In particular, the following pathologies
were revealed at the examination of persons in group
II - general atherosclerosis, coronary cardiosclerosis
(15.4%), hypertension (25.6%), CHD (12.8%), diabetes
mellitus (17.9%), chronic bronchitis, pulmonary
emphysema, pneumosclerosis (12.8%), pulmonary
tuberculosis
(2.6%),
gastrointestinal
diseases
(duodenal ulcer, gastric ulcer, chronic gastritis) (12.8%).
An analysis of postoperative complications developed
in inpatients with thermal trauma was also performed.
1.
One frequent postoperative complication was
suppuration of the donor area. As the donor area
68
Volume 04 Issue 03-2022
The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
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2689-1026)
VOLUME
04
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03
Pages:
65-69
SJIF
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FACTOR
(2020:
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(2021:
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64
)
(2022:
6.
319
)
OCLC
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1121105510
METADATA
IF
–
7.569
Publisher:
The USA Journals
was insufficiently treated in the postoperative
period.
2.
Pneumonia mainly occurred in those with upper
airway burns and prolonged recumbency.
3.
Lysis of the autograft was observed in patients
with burns on the posterior surface of the torso
who were in a supine position on this surface for a
long time, which contributed to displacement of
the graft and its partial lysis. In the later post-
traumatic period the most frequent immediate
complications are pneumonia, sepsis, renal and
liver failure, DIC, blood loss due to bleeding from
acute stomach ulcers, acute cardiovascular failure,
pulmonary and cerebral oedema, etc.
In determining the severity of bodily injuries in Group I
examinees the following was observed - mild bodily
injuries without health disorder in 2 persons (9,5%),
mild with health disorder in 7 persons (33,3%),
moderate in 1 (4,8%), severe in 10 (47,6%). In one case
(4.8%) the degree of severity was not specified.
CONCLUSIONS
Thus, the findings indicate that thermal trauma is
mainly caused by exposure to high temperature
(flame,
flammable
liquid),
and
the
gender
predominates in men of working age. To determine the
area of the injury, the burn surface area can be
determined (as a percentage of the div surface); the
depth of the injury must be determined separately. The
severity of injuries due to high temperatures must be
assessed in terms of the duration of the disability or the
extent
of
permanent
disability.
Concomitant
pathologies (cardiovascular diseases, gastrointestinal
diseases, diabetes mellitus, etc.) that are found in
thermal trauma lead to slower healing of the burn
surface, development of complications (suppuration,
etc.), as well as exacerbation of the aforementioned
diseases. Therefore, these characteristics must be
taken into account when determining the severity of
injuries, especially with regard to the criterion of the
duration of the health disorder.
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The American Journal of Medical Sciences and Pharmaceutical Research
(ISSN
–
2689-1026)
VOLUME
04
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03
Pages:
65-69
SJIF
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