分析钝器创伤的能力对于破译有关伤害机制的有价值线索以及作为医学法律调查的证据至关重要。在过去的十年中,已经研究了替代光源(ALS)的使用,并建议在瘀伤评估期间优于常规白光(CWL)。为了响应全世界对该技术日益增长的兴趣,根据系统评价和荟萃分析(PRISMA)的首选报告项目对文献进行了系统综述,以探讨ALS检测和观察瘀伤的能力.从最初的4055条记录中确定,10项研究符合合格标准,并入选本综述.评估还包括一个新颖的框架,被称为SPICOT,进一步系统地评估法医文献中的科学证据和偏见风险。分析表明,红外或紫外光谱范围内的窄带波长在可视化或检测瘀伤方面并没有明显优于CWL。然而,可见光谱内的波长,特别是415nm与长通或带通黄色滤光片相结合,更有效。然而,大多数选定的研究只涉及ALS的敏感性,因此,只有在已知瘀伤的位置时,结果才可能被认为是有效的。需要进一步调查以了解ALS的特殊性,特别是如何使用外用化妆品,以前的伤口/疤痕组织,纹身,痣和雀斑可能会影响检测。在将ALS实施为常规实践之前,在前景讨论中也应考虑对增强的可视化创伤的解释的伦理关注。然而,这篇综述发现,可见光谱内的窄带ALS证明了改善损伤记录的潜力,在瘀伤的检测和可视化方面优于CWL。
The ability to analyze blunt-force trauma is crucial for deciphering valuable clues concerning mechanisms of injury and as evidence for medico-legal investigations. The use of alternate light sources (ALS) has been studied over the past decade, and is proposed to outperform conventional white light (CWL) during bruise assessments. In response to the growing interest of the technology worldwide, a systematic
review of the literature was conducted according to the Preferred Reporting Items for Systematic
Review and Meta-Analysis (PRISMA) to address the ability of ALS to detect and visualize bruising. From an initial 4055 records identified, ten studies met the eligibly criteria and were selected for this
review. Evaluation also included a novel framework, referred to as SPICOT, to further systematically assess both scientific evidence and risk of bias in forensic literature. Analysis reveals that narrowband wavelengths within in the infrared or ultraviolet spectral ranges do not significantly outperform CWL in visualizing or detecting bruising. However, wavelengths within the visible spectrum, particularly 415 nm combined with longpass or bandpass yellow filters, are more effective. However, the majority of selected studies only address the sensitivity of ALS, and therefore, results may only be considered valid when the location of a bruise is known. Further investigation is required to understand the specificity of ALS, in particular how the use of topical cosmetic products, previous wounds/scar-tissue, tattoos, moles and freckles may affect detection. The ethical concern regarding the interpretation of enhanced visualized trauma should also be considered in prospect discussions prior to implementing ALS into routine practice. Nevertheless, this
review finds that narrowband ALS within the visible spectrum demonstrates potential for improved injury documentation, outperforming CWL in the detection and visualization of bruising.