The ageing of bruises: A review and study of the colour changes with time

Bruises: Is it a case of “the more we know, the less we understand?”

“…Of note, even then there was disagreement among the texts in the exact timeline for these color changes [4][5][6][7]. The paper by Langlois and Gresham in 1990 debunked this certainty, and demonstrated that the only reliable comment that could be made was that yellow bruises were likely to be older than 18 h [8]. It should be noted, however, that this study did rely on photographs of bruises, which may present additional complication in interpretation (see below).…”

Origin and assessment of bruises in beef cattle at slaughter

“…The most common techniques used by practitioners to estimate the age of human skin bruises are either direct visual evaluation or inspection of photos (Langlois and Gresham, 1991). These methods are subjective, rely on experience and individual visual perception, and depend on ambient lighting and photographic quality (Randeberg et al, 2006).…”

“…The latter accounts for the numerous studies carried out in recent decades with the aim of developing a method for ageing bruises in human skin (Langlois and Gresham, 1991;Betz, 1994;Sawaguchi et al, 2000;Bariciak et al, 2003;Bonelli et al, 2003;Hughes et al, 2004 andRandeberg et al, 2006;Grellner and Madea, 2007;Kondo, 2007).…”

“…From extensive studies of different species (Langlois and Gresham, 1991;Langlois, 2007), it was concluded that only the appearance of a yellow colour may provide information on the age of a bruise, recommending that no attempt should be made to analyse other colours such as blue, green, purple, black, orange, brown or red, because a bruise may contain different colours at any one time (Maguire et al, 2005). Langlois (2007) stated that if yellow colour is seen in a bruise, the bruise is not recent and should be aged as older than 18 h. Nevertheless, it has not been accurately established when yellow colour appears in a bruise and this may also differ between species.…”

Development of a surrogate bruising detection system to describe potential bruising patterns associated with common childhood falls.

“…Additionally, intrinsic factors related to the physiological and anatomical structures, such as architecture of the skin, soft tissue thickness, toughness of skin, fat content, vessel fragility, and presence and depth of underlying bone add to the complexity of this physiological event 64 . Variables such as blood platelet levels, systemic blood pressure, vascular diseases and vasoactive or anticoagulant drug use in addition to nutritional and allergy related disorders can have a great influence on the presence, absence and variability in intensity of bruise 25,[64][65][66] . This implies that the minimum load to cause bruising, the "bruising threshold", varies across individuals.…”