Abstract
Background
To obtain forensic evidence of blunt trauma injury, physical examination (PE) is necessary but is only valid when an injury is visible. Identification of previously invisible injuries through the application of ultraviolet (UV) radiation is a phenomenon that has been known for decades, but to date has only drawn little attention in German legal medicine.
Objectives
To analyze at what point in time UV examination (UVE) can be used as an additional noninvasive tool to identify potential blunt trauma injuries, especially when visual signs are absent.
Materials and methods
Retrospective analysis of reports from 28 individuals who underwent forensic examination for blunt trauma injury, including the use of UV-induced fluorescence.
Results
In all, 28 subjects presented with 294 claimed injuries of which 205 were forensically verified to correspond with the mechanism of injury. Injuries were visible longer with an increasing intensity of violence. UVE identified 62 % of these potential injuries in a time span of up to 31 weeks after blunt trauma, whereas PE alone identified only 19 %.
Conclusion
UVE seems to be an essential aid for blunt trauma identification from the first moment of injury and is superior to using PE alone. Therefore, UVE should be used as an additional tool with every PE, especially if the suspected injuries are older than 1 week, to obtain complete evidence of blunt trauma injuries.
Zusammenfassung
Hintergrund
Zur forensischen Dokumentation stumpfer Gewalteinwirkungen ist eine körperliche Untersuchung (PE) erforderlich, aber meist nur aussagekräftig, wenn Verletzungen sichtbar sind. Durch den Einsatz von Ultraviolettstrahlung (UV) lassen sich äußerlich nicht abzugrenzende Verletzungen sichtbar machen. Obwohl dieses Phänomen seit Jahrzehnten bekannt ist, findet es in den deutschen Instituten bisher wenig Beachtung.
Fragestellung
Ab welchem Zeitpunkt und bis zu welchem Verletzungsalter kann eine UV-Untersuchung (UVE) als ergänzende, nichtinvasive Methode zur PE angewandt werden, um mit bloßem Auge nicht (mehr) zu erkennende Verletzungen nachzuweisen?
Material und Methoden
Retrospektive Auswertung der rechtsmedizinischen Gutachten zu 28 körperlichen Untersuchungen nach stumpfen Gewalteinwirkungen, bei denen die Probanden jeweils auch mittels UV-induzierter Fluoreszenz untersucht wurden.
Ergebnisse
Die 28 Personen präsentierten sich mit 294 möglichen Verletzungen, von denen 205 Hämatome hinsichtlich ihrer Entstehungsart/ihres Entstehungszeitraums mit den anamestischen Angaben übereinstimmten. Die festgestellten Verletzungen waren umso länger sichtbar, je intensiver die Gewalteinwirkung erfolgte. Mittels UVE konnten 62 % der Hämatome bis 31 Wochen nach deren Entstehung nachgewiesen werden, während eine alleinige PE nur 19 % der Hämatome erfassen konnte.
Diskussion
Eine zusätzliche UVE scheint bereits zeitnah nach Verletzungsentstehung ergänzende Befunde zur Routine-PE beim Nachweis von Hämatomen zu liefern. Wir empfehlen eine standardisierte UVE nach allen PE, insbesondere wenn die potenziellen Verletzungen älter als eine Woche gewesen sein sollen. So können auch ältere Verletzungen dokumentiert werden.
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J. Glauche, B. Ondruschka, V. Wenzel, J. Dreßler, and C. Hädrich state that they have no conflicts of interest.
All studies on humans described in the present manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current, revised form). Informed consent was obtained from all patients included in studies.
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Benjamin Ondruschka and Carsten Hädrich have contributed equally to this work.
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Glauche, J., Ondruschka, B., Wenzel, V. et al. Examination of invisible injuries. Rechtsmedizin 25, 543–547 (2015). https://doi.org/10.1007/s00194-015-0053-2
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DOI: https://doi.org/10.1007/s00194-015-0053-2