A contact gunshot wound to the temple is examined at autopsy. The entry wound shows a stellate laceration, inward beveling of the skull, and extensive blackening and singeing of wound margins with gun smoke deposits in the wound track. A 'cherry-red' discoloration of the skin around the wound is noted. What is the significance of the cherry-red color?

• A It indicates carbon monoxide (CO) from propellant combustion forming carboxyhemoglobin in local tissues — confirms contact range discharge ✓
• B It is a postmortem artifact from putrefaction with hemolysis
• C It indicates high-velocity bullet causing vascular blush from cavitation
• D It represents vital reaction confirming the individual survived briefly after shooting

Explanation

In contact and close-range gunshot wounds, propellant gases (which contain carbon monoxide, CO) are discharged directly into the wound and surrounding tissues. CO has approximately 240 times greater affinity for hemoglobin than oxygen, forming cherry-red carboxyhemoglobin (HbCO) in local tissues. This produces the characteristic cherry-red coloration of tissues around the wound and in the wound track — it is specific to contact or near-contact range discharge where CO-containing gas enters tissues. It is NOT a vital reaction (A correctly states it confirms range); putrefactive changes (B) produce greenish discoloration; cavitation effects (C) are mechanical and do not produce cherry-red color.

Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.

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Written and medically reviewed by the StethoPrep medical team.