The Difficult Task of Interpreting Cut Marks, Gunshot Wounds and Ligature Marks on the Skin: A Cautionary Note

The morphological assessment of skin injuries is a stronghold of forensic pathology and relies upon standard “rules” for a correct interpretation. But are these parameters reliable? When is the interpretation dangerously difficult? This study aims at quantifying the difficulties in the assessment of stab wounds, gunshot wounds and ligature marks by the observation of photographs in three questionnaires given to 11 experts (forensic pathologists) and 11 non-experts (trainees in forensic pathology). For stab wounds the overall percentage of correct answers was 47.5%, 56.9% for type of blade and 64.2% for type of edge. Gunshot wounds were correctly assessed only in 41.3% of cases. Finally, only in 47.1% of the cases a correct match ligature mark/object of constraint was found. The results show that wounds on the skin can frequently be misinterpreted if classification is strictly based on only morphological parameters; the judgment should therefore be based on an overall evaluation of all evidences, including also those provided by more advanced technological analyses (for example, SEM-EDS for the search of residues, radiological analyses, etc.).