Postmortem Changes and Artifacts Occurring During the Early Postmortem Interval

The underlying biological processes that a human body or its remains undergoes after death are complex and, as with other biological phenomena, there is a broad range of variables influencing postmortem changes by the alteration of the underlying progress of tissue destruction. The understanding of the resultant postmortem changes is of great importance for the forensic pathologist and medical examiner. As a general rule, changes in ambient temperature tend to alter the rate but do not change the underlying biological mechanisms of postmortem changes. The manifestation of putrefaction may cause interpretational problems and, accordingly, a death may seem suspicious in a given case. Putrefaction may mask traumatic injuries an invidual sustained before death. However, purging of putrefaction fluid from the mouth and nostrils is frequently confused with blood, for example, deriving from antemortem facial injuries, by those investigators unfamiliar with the phenomenon. When tight clothing is worn by the deceased, putrefactive bloating of the neck region may lead to cutaneous alterations mimicking strangulation marks. In contrast to livor mortis, vibices, rigor mortis, autolysis, and putrefaction, all of which are known as postmortem phenomena that are frequently observed in the death investigator’s daily practice, more uncommon postmortem changes that do only occur occasionally and under specific intra-individual or environmental conditions may be interpreted falsely by the inexperienced. Abrasions and lacerations on the skin may be produced by manipulation of the body during postmortem handling, transportation, and storage. Urine may cause extensive skin damage postmortem to an infant on the perigenital skin areas that were in contact with a urine-soaked diaper postmortem. One has to be aware to differentiate such postmortem skin changes from vitally acquired alterations and not to interpret them uncritically as signs of neglect prior to death. Postmortem hypostasis in the muscles located in the lateral submalleolar region and the thenar eminence may mimic antemortem bruising. It generally is impossible to draw any definite conclusions concerning the time of death by the appearance of a single postmortem change, or conversely, to predict what postmortem changes are to be expected in a given case after a particular postmortem interval has elapsed. Nevertheless, in some distinct cases, particularly the presence and picture of several postmortem changes may, when analyzed combined with the rectal temperature of the deceased, give the death investigator valuable hints concerning the time frame in wich the subject most probably has died.