PUTREFACTIONPUTREFACTION

By Dr. NaveenBy Dr. Naveen

Putrefaction:Putrefaction:

DecompositionDecomposition ““It is the process in which the complex It is the process in which the complex

organic substances are converted into organic substances are converted into simpler one by the action of the proteolytic simpler one by the action of the proteolytic enzymes of the tissue and living saprophytic enzymes of the tissue and living saprophytic microorganisms”.microorganisms”.

Causes:Causes:

Autolysis-Autolysis-

Cl.welchi,streptococci,staphylococci,proteus,diCl.welchi,streptococci,staphylococci,proteus,diphtheroids etc.phtheroids etc.

Stages of putrefaction:Stages of putrefaction:

1.colour change1.colour change 2.Development of foul smelling gases2.Development of foul smelling gases 3.Appearance of maggots3.Appearance of maggots 4.Colliquative putrifaction4.Colliquative putrifaction

1.colour change:1.colour change: -externally: 1-externally: 1stst seen in the abdominal skin,caecum seen in the abdominal skin,caecum greenish discolorationgreenish discoloration -internally:-internally: under surface of the liverunder surface of the liver-Appears : 12-18 hrs. summer-Appears : 12-18 hrs. summer 1- 2 days winter1- 2 days winter-it is due to decomposituon of haemoglobin into greenish -it is due to decomposituon of haemoglobin into greenish

compound that stain the skin.compound that stain the skin.-it usually starts in right iliac fossa.-it usually starts in right iliac fossa.-Extends to external genitalia,chest,neck,face,arms and legs-Extends to external genitalia,chest,neck,face,arms and legs-Deepens,dark green , dark blue-Deepens,dark green , dark blue

2.Development of foul smelling gases:2.Development of foul smelling gases: --nauseating and unpleasant smellnauseating and unpleasant smell -later collects in the abdomen-later collects in the abdomen -abdomen tense and distended-abdomen tense and distended -collects in the hollow visceras & t/s-collects in the hollow visceras & t/s -blisters-blisters -faces swollen-faces swollen -rectum protrudes-rectum protrudes Time of developmentTime of development:: -12-18 hrs summer-12-18 hrs summer -1-2 days winter-1-2 days winter

3.appearance of maggots:3.appearance of maggots: -flies are attracted by the smell-flies are attracted by the smell -lay their eggs-lay their eggs -forms larva(maggots)-forms larva(maggots) -hatch into pupae( in 4-5 days)-hatch into pupae( in 4-5 days) -adult fly ( another 4-5 days)-adult fly ( another 4-5 days) - scalp & nails become loose- scalp & nails become loose - teeth become loose- teeth become loose - sutures of the skull- sutures of the skull -liquified brain -liquified brain

4.colliquative putrifaction:4.colliquative putrifaction:

-after 5-10 days-after 5-10 days

-abdomen burst-abdomen burst

- in children thorax also bursts- in children thorax also bursts

- T/s becomes loose,seperated from bones - T/s becomes loose,seperated from bones and falls offand falls off

- bones are distroyed- bones are distroyed

Time during putrefactionTime during putrefaction Color changes;Color changes; 12-18 hrs summer12-18 hrs summer 1-2 days winter1-2 days winter Development of foul smelling gases;Development of foul smelling gases; -gases collects in intestine:12-18 hrs-gases collects in intestine:12-18 hrs -collects in hollow viscera: 24-36 hrs-collects in hollow viscera: 24-36 hrs -blisters: 36-48 hrs-blisters: 36-48 hrs -swollen faces: 36-48 hrs.-swollen faces: 36-48 hrs. -rectum protrudes: 48-72 hrs.-rectum protrudes: 48-72 hrs. Appearance of maggots: 18-36 hrsAppearance of maggots: 18-36 hrs Teeth fall out: 3-7 daysTeeth fall out: 3-7 days Sutures of the skull become loose: 5-12 daysSutures of the skull become loose: 5-12 days Body is skeletonized : 1-3 monthsBody is skeletonized : 1-3 months

Putrefaction rapid in :Putrefaction rapid in : septicaemia,septicaemia, peritonitisperitonitis intestinal obstructionintestinal obstruction pyelonephritispyelonephritis women dying after child birthwomen dying after child birth Slow in :Slow in : anaemiaanaemia malnutritionmalnutrition poisoningpoisoning if submerged in waterif submerged in water

Putrefaction of internal organ :Putrefaction of internal organ :

According to Taylor:According to Taylor: -intestine and stomach-intestine and stomach -liver -liver -spleen-spleen -brain-brain -lungs-lungs -kidney-kidney -bladder-bladder -prostate /testis (M)-prostate /testis (M) -Uterus,ovaries (F)-Uterus,ovaries (F)

According to Reddy:According to Reddy: -Larynx and trachea-Larynx and trachea -stomach/intestine/spleen-stomach/intestine/spleen -liver/lungs-liver/lungs -brain-brain -heart-heart -kidney/bladder/uterus-kidney/bladder/uterus -skin/muscle tendons-skin/muscle tendons -bones-bones

!!!!!!

SAPONIFICATIONSAPONIFICATION

Adipocere formationAdipocere formation ““It is the modification of putrefaction in which It is the modification of putrefaction in which

the body fat is converted into a brown wax the body fat is converted into a brown wax like substances which occurs in bodies like substances which occurs in bodies submerged under water for appreciable time submerged under water for appreciable time or burried in moist grave or water lodged or burried in moist grave or water lodged soil”.soil”.

Mechanism:Mechanism:

-the fatty t/s changes into substance known -the fatty t/s changes into substance known as adipocere.as adipocere.

-it is due to gradual hydrolysis of preexisting -it is due to gradual hydrolysis of preexisting fats into higher fatty acid.fats into higher fatty acid.

Time required for adipocere Time required for adipocere formation:formation:

Varies greatlyVaries greatly In summer : 3 weeksIn summer : 3 weeks

may take 6wks- 12 monthsmay take 6wks- 12 months In winter : may take shorter timeIn winter : may take shorter time

not exactly knownnot exactly known

Distribution:Distribution:

Common site:Common site:

face/buttock/breast & abdomenface/buttock/breast & abdomen Less common:Less common:

limbs/chest walllimbs/chest wall

Medicolegal importance:Medicolegal importance:

Helps in identification long after deathHelps in identification long after death Causes of the death can be recognizedCauses of the death can be recognized May indicate place of burialMay indicate place of burial Can estimate timeCan estimate time

Mummification:Mummification:

DesicationDesication ““It is the drying and shrivelling of the body It is the drying and shrivelling of the body

tissue due to rapid dehydration of the body tissue due to rapid dehydration of the body in a dry and hot climate and which retains in a dry and hot climate and which retains the natural appearance of the body.”the natural appearance of the body.”

Factors influencing Mummification:Factors influencing Mummification:

1.Absence of dampness1.Absence of dampness 2.Dry or warmed air2.Dry or warmed air 3.Marked dehydration before death3.Marked dehydration before death

Time required:Time required:

Not exactly knownNot exactly known Months to yearMonths to year

Medicolegal importance:Medicolegal importance:

IdentificationIdentification Cause of death Cause of death Time ,, ,,Time ,, ,, Place ,, ,,Place ,, ,,

Exhumation:Exhumation:

““Exhumation means digging out of an Exhumation means digging out of an already buried body from the grave for such already buried body from the grave for such medicolegal purpose as identification or medicolegal purpose as identification or autopsy in case of suspicious death from autopsy in case of suspicious death from foul play.”foul play.”

Who can order exhumation??Who can order exhumation??

written order from district magistrate or written order from district magistrate or any other magistrate inpowered by the any other magistrate inpowered by the government. government.

Indication :Indication :

In any suspicious of foul play or poisoningIn any suspicious of foul play or poisoning To established identityTo established identity To detect the time of deathTo detect the time of death

Procedure:Procedure: Written order by the magistrateWritten order by the magistrate Exhumated under the supervision of MO,in the presence of police Exhumated under the supervision of MO,in the presence of police

officerofficer To be carried out in day lightTo be carried out in day light Exact situation of the graveExact situation of the grave If possible identify by name plateIf possible identify by name plate Wear gloves and maskWear gloves and mask Collect several samples of earth in contact with the bodyCollect several samples of earth in contact with the body Seal it and label itSeal it and label it Take out the body from the graveTake out the body from the grave Identification by relatives and friendsIdentification by relatives and friends PM examinationPM examination Preserve the viscerasPreserve the visceras

Following parts should be sent for chemical analysis:Following parts should be sent for chemical analysis: -soil-soil -Hair head/pubic hair-Hair head/pubic hair -nail,teeth-nail,teeth -bones-bones -heart-heart -stomach-stomach -intestine-intestine -liver-liver -spleen-spleen -kidney-kidney