A victim of high-voltage (>1000V) electrical injury is found at the scene with a charred entry wound on the right palm and an exit wound on the left foot. The MOST reliable autopsy feature that distinguishes ante-mortem from post-mortem electrical burns in this high-voltage case is:

• A Histological evidence of vital reaction (inflammatory infiltrate, vascular hyperaemia) at the burn margin ✓
• B Presence of an exit wound, which cannot form post-mortem
• C The characteristic metallic deposition at the wound site from the conductor
• D The depth of charring indicating the voltage involved

Explanation

Distinguishing antemortem from postmortem burns requires evidence of a vital reaction. Histologically, antemortem electrical burns show epidermal pallisading/vacuolation (specific to electrical injury), vascular congestion, perivascular inflammatory infiltrate, and dermal collagen changes — all signs of biological response to injury. Exit wounds can form from current flowing through a post-mortem body via an external power source and are not specific to ante-mortem injury. Metallic deposition and charring depth reflect the nature of the current, not the vital state.

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.