European Journal of Cardiovascular Medicine

Background: Neck constriction deaths, encompassing strangulation and hanging, present significant challenges for forensic investigations. The intricate nature of injuries involved necessitates a comprehensive evaluation to accurately determine the cause and manner of death. This study explores the current state of forensic assessment of neck injuries from a surgeon's perspective, addressing the complexities of differentiating between homicidal, suicidal, and accidental deaths. Materials and Methods: A mixed-methods approach was utilized, combining quantitative data from 200 forensic case files over the past five years with qualitative insights from semi-structured interviews with ten experienced forensic surgeons. The study involved a retrospective analysis to identify correlations between the type of neck injury and forensic conclusions, alongside thematic analysis of expert interviews to uncover challenges and technological integration in forensic assessments. Results: The majority of neck constriction deaths were male (60%) and within the 18-45 age group (50%), with hanging identified as the predominant method (50%). Soft tissue hemorrhage and skin abrasions/lacerations were prevalent across all cases, while hyoid bone fractures and laryngeal injuries were more common in strangulation, indicating a more direct application of force. Expert interviews highlighted the importance of technological advances, the need for standardization in forensic practice, and the value of interdisciplinary collaboration. Conclusion: The findings underscore the critical role of surgical expertise in interpreting complex neck injuries and the necessity for an interdisciplinary approach in forensic assessments. Continuous advancements in forensic methodologies and technological integration are essential to address the challenges in distinguishing between different manners of death. The study advocates for ongoing education and standardization of practices to enhance the precision and reliability of forensic conclusions.