Joki-Erkkilä Minna, Rainio Juha, Huhtala Heini, Salonen Aki, Karhunen Pekka J
Departments of Gynecology and Obstetrics and Forensic Child Psychiatry, Tampere University Hospital, Finland.
Department of Forensic Medicine, School of Medicine, University of Tampere, and Institute for Health and Welfare, Finland.
Forensic Sci Int. 2014 Sep;242:293-298. doi: 10.1016/j.forsciint.2014.06.005. Epub 2014 Jun 12.
New clinical forensic examination techniques for sexual assaults have not been introduced over the last few decades. We evaluated the benefit of ultraviolet light compared to white light for detecting minor anogenital injuries and scars, following consensual sexual intercourse among adult volunteers.
A prospective study comparing female genital findings utilising white and ultraviolet light. A colposcopy with photographic documentation was used.
Personal invitation to healthcare students, hospital employees or acquaintances to volunteer for a gynecological examination, with a focus on clinical forensic aspects.
Eighty-eight adult female volunteers were recruited for the study. The examination was performed after consensual intercourse. Age ranged from 20 to 52 years (median 26.5 years).
Presence of acute findings and scars in the genital area using white and UV-light.
Acute genital injury rate was 14.8% under white light colposcopy and 23.0% using UV light. Submucosal hemorrhages in the genital area were documented significantly better under UV-light than white light (14.9% vs. 6.8%; p=0.016), whereas petechiaes (4.5%) and abrasions (2.3%) were detected using either method. UV-light revealed significantly more often delivery-associated genital scars compared to white light (39.8% vs. 31.8%; p=0.016). Furthermore, 10 out of 31 (33.3%) women had no residual anogenital skin or mucosal surface findings, despite a prior episiotomy or rupture of the vaginal outlet wall during delivery, supporting its enormous ability to heal even after major trauma.
UV-light may provide additional value for the evaluation of physical findings in clinical forensic examinations after sexual assault, and is especially useful in detecting otherwise invisible early submucosal hemorrhages and scars.
在过去几十年里，尚未引入用于性侵犯的新临床法医检查技术。我们评估了在成年志愿者进行自愿性交后，与白光相比，紫外线在检测轻微肛门生殖器损伤和疤痕方面的益处。
一项前瞻性研究，比较使用白光和紫外线观察女性生殖器的结果。采用阴道镜检查并进行摄影记录。
通过个人邀请医学生、医院员工或熟人自愿参加妇科检查，重点关注临床法医方面。
招募了88名成年女性志愿者参与研究。检查在自愿性交后进行。年龄范围为20至52岁（中位数26.5岁）。
使用白光和紫外线观察生殖器区域急性损伤和疤痕的情况。
在阴道镜白光检查下，急性生殖器损伤率为14.8%，使用紫外线时为23.0%。紫外线观察下，生殖器区域黏膜下出血的记录明显优于白光（14.9%对6.8%；p = 0.016），而两种方法检测到的瘀点（4.5%）和擦伤（2.3%）情况相似。与白光相比，紫外线更常发现与分娩相关的生殖器疤痕（39.8%对31.8%；p = 0.016）。此外，31名女性中有10名（33.3%）尽管在分娩时有会阴切开术或阴道出口壁破裂，但肛门生殖器皮肤或黏膜表面没有残留损伤，这表明即使在遭受重大创伤后，其愈合能力也很强。
紫外线可能为性侵犯后临床法医检查中的身体检查结果评估提供额外价值，尤其有助于检测其他情况下不可见的早期黏膜下出血和疤痕。
