At autopsy of a severely charred body, a linear split is present over the flexor aspect of the elbow. The margins are irregular and jagged, the wound is completely bloodless, the surrounding skin shows no zone of hyperaemia, and coagulated subcutaneous fat protrudes through the defect. This lesion should be interpreted as:

• A Antemortem laceration sustained while escaping the fire
• B Heat rupture of the skin ✓
• C Postmortem incised wound inflicted before burning
• D Postmortem artefact of body handling during recovery

Explanation

Heat ruptures occur when contracted, desiccated skin splits over joints and bony prominences in badly charred bodies. They are bloodless, have irregular jagged margins without contusion or hyperaemia, show no tissue bridging, and coagulated fat may extrude from the base. An antemortem laceration would show bruising, infiltration of blood in the wound edges and a vital reaction. Handling artefacts do not produce splits with extruded coagulated fat at typical sites of flexion.

Reference: Knight's Forensic Pathology, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.