7.1 Physical Injuries: Revised Penal Code Classes, Wounds, Gunshot Injuries, Asphyxia & Burns

Why this area matters

The TOS includes "evidence of physical injury" under the 50-item nature-of-medicolegal-cases area. When you write the healing or incapacity period on a medicolegal certificate, you are effectively choosing the crime the prosecutor will charge. You must therefore classify injuries correctly, describe them precisely, and read their pattern for weapon, range and manner.

Forensic Traumatology: Physical Injuries under the Revised Penal Code

The Philippine Revised Penal Code (RPC, Act No. 3815) classifies non-fatal physical injuries based on the duration of medical attendance or the degree of physical incapacity for normal work.

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Wound Morphology: Blunt vs. Sharp Force

• Abrasions: Superficial injuries limited to the epidermis and papillary dermis caused by friction. Graze/brush abrasions display epidermal tags pointing away from the direction of force, revealing the vector of injury. Patterned abrasions mirror the profile of the striking object (e.g., tire tread marks, radiator grille patterns).
• Contusions (Bruises): Effusion of blood into subcutaneous tissues secondary to mechanical rupture of capillaries with an intact overlying epidermis. Color evolution reflects hemoglobin catabolism: dark red/purple (0-24 hours) $\rightarrow$ blue/livid (1-3 days) $\rightarrow$ green/biliverdin (4-7 days) $\rightarrow$ yellow/bilirubin (7-14 days) $\rightarrow$ complete clearance.
• Lacerations: Full-thickness tears or splits in the skin and subcutaneous tissue produced by blunt crushing, shearing, or stretching forces exceeding the tensile strength of the tissue. Distinctive features: irregular, abraded, and contused margins; presence of tissue bridging (intact nerves, blood vessels, and elastic fibers spanning across the depths of the wound floor); and absence of cleanly divided hair bulbs.
• Incised Wounds: Clean linear cuts produced by sharp-edged instruments where the surface length exceeds the depth. Distinctive features: sharp, well-defined margins without abrasion or contusion; complete absence of tissue bridging; cleanly severed hair shafts; and tailing at the exit end indicating the direction of stroke.
• Stab Wounds: Penetrating sharp-force injuries where the depth of the wound tract exceeds its surface length, caused by pointed implements. Examination reveals the orientation of Langer's lines of skin tension and allows reconstruction of blade geometry (single-edged vs. double-edged dagger).

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Forensic Ballistics: Gunshot Wounds

Gunshot wounds are categorized into four range-dependent patterns based on the presence and distribution of propellant discharge residues (soot, heat, and powder granules).

Entrance Wound vs. Exit Wound Comparison:
Entrance: Inverted margins, abrasion collar present, bullet wipe ring, round/oval defect, smaller diameter.
Exit: Everted margins, NO abrasion collar, NO bullet wipe, NO soot/stippling, irregular/slit-like/stellate, larger diameter.

Other Revised Penal Code provisions on injury

• Mutilation (Art. 262): intentionally depriving a person, totally or partially, of an essential organ for reproduction (the gravest form), or any other intentional mutilation.
• Administering injurious substances (Art. 264): serious injury caused, without intent to kill, by knowingly giving harmful substances or beverages.
• Death or injuries inflicted under exceptional circumstances (Art. 247): a legally married person who surprises his or her spouse in the act of sexual intercourse with another and kills or seriously injures either of them suffers only destierro.
• Tumultuous affray (Arts. 251 and 252): used when the person who caused the death or injury cannot be identified.

Vital reaction: was the wound inflicted before or after death?

Antemortem wounds gape because of tissue retraction, bleed into the surrounding tissue (extravasation that does not wash away), and show inflammation and early healing if the person survived for hours or more. Postmortem wounds have bloodless, non-retracted margins with no infiltration. Histology (leukocyte infiltration, fibrin) and the incision test (used to tell contusion from livor) help when findings are borderline.

Suicide, homicide or accident?

Always integrate the scene, the history and the autopsy. Patterns are suggestive, not conclusive.

Asphyxial deaths

Asphyxia means interference with oxygen uptake or use. Classic but non-specific signs include facial congestion and cyanosis, petechial hemorrhages (Tardieu spots) of the conjunctivae, face and serosal surfaces, and fluid dark blood.

"Washerwoman" wrinkling of the hands and feet shows only immersion, not drowning; it also occurs when a dead body is placed in water. Absence of froth and diatoms in a body pulled from water raises the possibility of death before immersion.

Burns and electrical injuries

• Thermal burns: classified by depth (superficial, partial-thickness, full-thickness) and extent (rule of nines). In fire deaths, soot in the airways below the vocal cords and raised carboxyhemoglobin prove the victim was breathing during the fire. Their absence suggests death before the fire, as in a burned body used to conceal a homicide. Heat causes pugilistic posture and heat ruptures of the skin that can mimic wounds, and heat hematomas (extradural) that must not be mistaken for trauma.
• Scalds: caused by hot liquids. Sharp immersion lines on the buttocks or in a stocking-glove pattern in a child suggest abuse.
• Electrocution: a small, firm, pale, crater-like entry mark (Joule burn), often on the hand, with a possible exit mark. Death is usually from ventricular fibrillation with alternating current.
• Lightning: arborescent Lichtenberg figures on the skin, burns and magnetized metal objects.