Single fatal stab wounds tend to involve the chest in homicides and suicides (6). Suicides with multiple wounds typically show extremity injuries (6). Multiple mutilating injuries suggest homicide (17). Ninety-eight wounds were seen in one homicide victim (3). One study revealed that suicide victims averaged 14.4 sharp injuries, compared with homicide victims who had a mean of 8.8 (average number of stab injuries/person, suicides = 6.8; homicides = 5.6; average number of cut injuries/person, suicides = 15.0, homicides = 3.5) (8). A significant number of suicide cases have more than one wound, but a single injury does not exclude a suicide (8,12,13,22). Single self-inflicted stab wounds of the extremities (e.g., involving the femoral artery) have been observed (8). Single incisions (e.g., radial or ulnar artery at wrist level) have been noted in suicides (Figs. 20 and 21; ref. 13). Single suicidal stab wound cases involving the abdomen are described (see Subheading 4.3.1; Fig. 6; ref. 8).
Vertical chest stab wounds tend to be seen in homicides (6,87). In a Stockholm study, homicidal stab wounds tended to be vertical and directed up and to the right of the deceased, whereas self-inflicted wounds were more likely horizontal and directed up and to the left of the victim (Fig. 22; ref. 13). The difference between the number of horizontal wounds in the chest in homicides and suicides was not significant in one series, but another study found that the majority of self-inflicted stab wounds to the left chest were aligned horizontally (6,9). The usual suicidal neck stab is downward (10). Suicidal stab wounds to the upper abdomen can be considered stabs to the heart, as the tracks are usually directed upward (9).
The determination of the direction of infliction of an incised wound is problematic (88). Incised wounds tend to be deeper at their origin becoming more superficial at their terminal ends, but this is not invariable (see Subheading 4.4.; Fig. 23; and ref. 88). By scanning electron microscopy, a lateral accessory tail has been described at the origin of an incision, particularly noticeable when the wound direction is perpendicular to Langer's lines (88).
Self-inflicted wounds tend to be grouped in one area of the body (Fig. 22; ref. 10).
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