ABSTRACT
Although the field of surgery is broad, evidence that surgery has taken place is often obvious and should point the investigator toward the most likely surgical specialist who will be able to advise them. The effect of surgery is to produce a controlled injury to the soft and hard tissues, and this is often done in response to traumatic injury. As such, this chapter links
well with the previous chapter on trauma. Surgery produces scarring and may leave behind artifacts such as implants, in addition to altering normal anatomy. We will provide the reader with a broad outline of the effect of surgical interventions on the human body, along with a guide to scar placement to help decide which surgical specialty has performed the operation. The reader should bear in mind that surgery, like all technologies, changes with time and differs in its practice between countries. This alone may provide useful information for the investigator. In addition, the reason for surgery may be deduced. For example, the discovery of a metal plate will indicate a previous fracture, or a pacemaker will indicate serious underlying heart disease. Finally, the effect of wound healing on the soft tissues is to produce scarring. Although this phenomenon is highly variable, careful observation based on the maturation of this process will provide a rough estimation of time from surgery or injury within the first year or two. The site and position of scars will inform the investigator much about the nature of the surgery (Figure 8.1 to Figure 8.6 and Figure 8.8).
